Copyright © 2003 by the European Society of Cardiology.
Regular Articles
Gender and restenosis after coronary artery stenting
Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar der Technischen Universität, Munich, Germany
* Corresponding author. Dr Adnan Kastrati Deutsches Herzzentrum Lazarettstr. 36 80636 München, Germany. Tel.: +49-89-12184577; fax: +49-89-12184593
E-mail address: kastrati{at}dhm.mhn.de
Received 18 February 2003; revised 2 June 2003; accepted 12 June 2003
Aims To examine the impact of sex on restenosis in a large cohort of consecutive patients undergoing coronary stenting and systematic angiographic and clinical follow-up.
Methods and results The study includes a cohort of 4374 consecutive patients (1025 women and 3349 men), undergoing coronary stenting for stable or unstable angina. Follow-up angiography at 6 months was performed in 80% of patients. Clinical events were assessed for a period of 1 year after the procedure. Main end-points of the study were angiographic and clinical restenosis at follow-up. Compared to men, women were older, presented more often with diabetes, smaller vessel size and shorter lesions. Clinical restenosis (need for reintervention) was found in 14.8% of women and 17.5% of men (P=0.048). The incidence of angiographic restenosis was significantly lower in women then in men (28.9% vs 33.9%, respectively, P=0.01). After adjustment for other covariates, women presented a 23% reduction of the risk of restenosis: odds ratio 0.77 (95% confidence interval 0.63 to 0.93). While a small vessel size was a risk factor for restenosis in both sexes, the influence of diabetes on restenosis was mostly confined to women.
Conclusion Compared with men, women present a lower risk of restenosis after coronary stenting despite a more preponderant presence of two major risk factors for restenosis, diabetes and small vessel size. There are sex-based differences in predictive factors of restenosis with diabetes having a particularly strong impact in women.
Key Words: Coronary artery disease • Gender • Restenosis • Stents
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