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Short- and long-term outcomes of coronary stenting in women versus men: results from the National Cardiovascular Data Registry Centers for Medicare & Medicaid services cohort.

Publication ,  Journal Article
Anderson, ML; Peterson, ED; Brennan, JM; Rao, SV; Dai, D; Anstrom, KJ; Piana, R; Popescu, A; Sedrakyan, A; Messenger, JC; Douglas, PS
Published in: Circulation
October 30, 2012

BACKGROUND: Conflicting evidence exists on sex-based outcomes after coronary stenting. METHODS AND RESULTS: Data on 426 996 patients ≥65 years old (42.3% women) from the National Cardiovascular Data Registry CathPCI Registry (2004-2008) were linked to Medicare inpatient claims to compare in-hospital outcomes by sex and long-term outcomes by sex and stent type. In-hospital complications were more frequent in women than in men: death (3869 [2.2%] versus 3737 [1.6%]; adjusted odds ratio, 1.41; 95% confidence interval [CI], 1.33-1.49), myocardial infarction (2365 [1.3%] versus 2858 [1.2%]; odds ratio, 1.19; 95% CI, 1.11-1.27), bleeding (7860 [4.4%] versus 5627 [2.3%]; odds ratio, 1.86; 95% CI, 1.79-1.93), and vascular complications (2381 [1.3%] versus 1648 [0.7%]; odds ratio, 1.85; 95% CI, 1.73-1.99). At 20.4 months, women had a lower adjusted risk of death (hazard ratio [HR], 0.92; 95% CI, 0.90-0.94) but similar rates of myocardial infarction, revascularization, and bleeding. Relative to bare metal stent use, drug-eluting stent use was associated with similar improved long-term outcomes in both sexes: death (women: adjusted HR, 0.78; 95% CI, 0.76-0.81; men: HR, 0.77; 95% CI, 0.74-0.79), myocardial infarction (women: HR, 0.79; 95% CI, 0.74-0.84; men: HR, 0.81; 95% CI, 0.77-0.85), and revascularization (women: HR, 0.93; 95% CI, 0.90-0.97; men: HR, 0.91; 95% CI, 0.88-0.94). There was no interaction between sex and stent type for long-term outcomes. CONCLUSIONS: In contemporary coronary stenting, women have a slightly higher procedural risk than men but have better long-term survival. In both sexes, use of a drug-eluting stent is associated with lower long-term likelihood for death, myocardial infarction, and revascularization.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

October 30, 2012

Volume

126

Issue

18

Start / End Page

2190 / 2199

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Stents
  • Sex Factors
  • Risk
  • Registries
  • Proportional Hazards Models
  • Postoperative Complications
  • Odds Ratio
  • Medicare
 

Citation

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Chicago
ICMJE
MLA
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Anderson, M. L., Peterson, E. D., Brennan, J. M., Rao, S. V., Dai, D., Anstrom, K. J., … Douglas, P. S. (2012). Short- and long-term outcomes of coronary stenting in women versus men: results from the National Cardiovascular Data Registry Centers for Medicare & Medicaid services cohort. Circulation, 126(18), 2190–2199. https://doi.org/10.1161/CIRCULATIONAHA.112.111369
Anderson, Monique L., Eric D. Peterson, J Matthew Brennan, Sunil V. Rao, David Dai, Kevin J. Anstrom, Robert Piana, et al. “Short- and long-term outcomes of coronary stenting in women versus men: results from the National Cardiovascular Data Registry Centers for Medicare & Medicaid services cohort.Circulation 126, no. 18 (October 30, 2012): 2190–99. https://doi.org/10.1161/CIRCULATIONAHA.112.111369.
Anderson, Monique L., et al. “Short- and long-term outcomes of coronary stenting in women versus men: results from the National Cardiovascular Data Registry Centers for Medicare & Medicaid services cohort.Circulation, vol. 126, no. 18, Oct. 2012, pp. 2190–99. Pubmed, doi:10.1161/CIRCULATIONAHA.112.111369.
Anderson ML, Peterson ED, Brennan JM, Rao SV, Dai D, Anstrom KJ, Piana R, Popescu A, Sedrakyan A, Messenger JC, Douglas PS. Short- and long-term outcomes of coronary stenting in women versus men: results from the National Cardiovascular Data Registry Centers for Medicare & Medicaid services cohort. Circulation. 2012 Oct 30;126(18):2190–2199.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

October 30, 2012

Volume

126

Issue

18

Start / End Page

2190 / 2199

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Stents
  • Sex Factors
  • Risk
  • Registries
  • Proportional Hazards Models
  • Postoperative Complications
  • Odds Ratio
  • Medicare