DES in Women Undergoing Complex PCI Revascularization

Apr 08, 2016
Font Size
A
A
A
Authors:
Giustino G, Baber U, Aquino M, et al.
Citation:
Safety and Efficacy of New-Generation Drug-Eluting Stents in Women Undergoing Complex Percutaneous Coronary Artery Revascularization: From the WIN-DES Collaborative Patient-Level Pooled Analysis. JACC Cardiovasc Interv 2016;9:674-684.
Summary By:
Hitinder S. Gurm, MBBS, FACC

Study Questions:

What is the safety and efficacy of second-generation drug-eluting stents (DES) in women?

Methods:

The WIN-DES investigators pooled patient-level data from women enrolled in 26 randomized trials of DES. The primary endpoint was major adverse cardiovascular events (MACE) defined as a composite of all-cause mortality, myocardial infarction, or target lesion revascularization (TLR) at 3 years of follow-up.

Results:

There were 10,241 women in the pooled database, of whom 4,629 (45%) underwent complex PCI, defined as the composite of total stent length >30 mm, ≥2 stents implanted, ≥2 lesions treated, or treatment of a bifurcation lesion. Women who underwent complex percutaneous coronary intervention (PCI) had higher 3-year risk of MACE (adjusted hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.45-1.83; p < 0.0001). The benefit of second-generation DES were seen in both patients with complex as well as those undergoing noncomplex PCI, with a significantly lower 3-year risk of MACE (adjusted HR, 0.81; 95% CI, 0.68-0.96), TLR (adjusted HR, 0.74; 95% CI, 0.57-0.95), and definite or probable stent thrombosis (adjusted HR, 0.50; 95% CI, 0.30-0.83). The risk of late stent thrombosis (<0.4%/3 years) in patients treated with second-generation DES was very low overall in both complex and noncomplex PCI.

Conclusions:

Second-generation DES have demonstrated remarkable safety and efficacy in women undergoing PCI.

Perspective:

The study adds to the growing data supporting the safety and efficacy of second-generation DES, and should provide further reassurance to patients undergoing contemporary PCI.

Keywords: Drug-Eluting Stents, Mortality, Myocardial Infarction, Myocardial Revascularization, Percutaneous Coronary Intervention, Risk, Stents, Thrombosis, Women


< Back to Listings