PMID- 22684377
OWN - NLM
STAT- MEDLINE
DCOM- 20121106
LR  - 20161125
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 24
IP  - 6
DP  - 2012 Jun
TI  - Gender differences in patients treated with the zotarolimus-eluting stent at a 
      tertiary medical center.
PG  - 256-60
AB  - BACKGROUND: Gender-related differences in long-term outcomes of patients 
      receiving the Endeavor zotarolimus-eluting stent (ZES) (Medtronic) have not been 
      well defined. In this study, we evaluate the differences between men (M) and 
      women (W) for 2-year target vessel failure (TVF) in an unselected consecutive 
      series of patients treated with the ZES at our institution. METHODS: Data on 197 
      consecutive patients (133 M, 64 W) stented with the ZES were retrospectively 
      analyzed. The primary endpoint of the study was to compare gender-related 
      outcomes in TVF, defined as the combined endpoint of cardiac death, non-fatal 
      myocardial infarction, and target vessel revascularization (TVR). Secondary 
      endpoints included TLR, TVR, acute stent thrombosis (ST) as defined by the 
      academic research consortium (ARC), and cardiac death. The cine angiograms of the 
      first consecutive 122 patients (79 M, 43 W) were independently reviewed by a 
      cardiologist blinded to clinical outcome and SYNTAX scoring was performed. 
      Follow-up was achieved using medical records and/or phone calls and was censored 
      at 730 days. Descriptive analysis was performed on all variables. Univariate 
      analysis compared the M and W cohorts. Logistic regression analysis modeling for 
      predictors of TVF was performed and survival analysis between the 2 groups was 
      plotted. RESULTS: The 2 groups were well matched for demographic, clinical, 
      angiographic, and procedural variables. Angiographic complexity was also 
      statistically similar between the 2 groups as judged by SYNTAX scoring (15.8 +/- 
      10.9 M vs 13.5 +/- 8.3 W; P=.197). At 2-year follow-up, TVF was 22.6% and 32.8% 
      (P=.684) with no statistical difference between TLR (18.1% M vs 12.8% W), TVR 
      (21.8% M vs 32.8% W), cardiac death (2.3% M vs 6.3% W), and definite and probable 
      stent thrombosis (2.26% M vs 3.13% W). Logistic regression analyses modeling for 
      age, gender, New York Heart Association (NYHA) class, non-left main (LM) 
      bifurcation lesions, ostial lesions, trifurcating LM, and pre-percutaneous 
      coronary intervention (PCI) lesion severity showed that a higher NYHA class (odds 
      ratio [OR], 2.68; P=.005), ostial lesions (OR, 5.68; P<.001), bifurcating non-LM 
      lesions (OR, 2.74; P=.015), and trifurcating LM lesions (OR, 28.24; P<.001) 
      predicted a higher TVF. Female gender (P=.086) and age (P=.09) were not 
      independent predictors of TVF. CONCLUSION: In this cohort of patients receiving 
      ZES, men and women had similar outcomes at 2-year follow-up consistent with 
      recent reports in the current era of PCI. Complex coronary anatomy (ostial, 
      non-LM bifurcations, and LM trifurcations) and advanced heart failure were 
      stronger predictors of higher TVF than gender and age.
FAU - Shammas, Nicolas W
AU  - Shammas NW
AD  - Midwest Cardiovascular Research Foundation, Davenport, IA 52803, USA. 
      Shammas@mchsi.com
FAU - Shammas, Gail A
AU  - Shammas GA
FAU - Lemke, Jon
AU  - Lemke J
FAU - Miller, Sue
AU  - Miller S
FAU - Meriner, Susan
AU  - Meriner S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
RN  - H4GXR80IZE (zotarolimus)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Academic Medical Centers
MH  - Aged
MH  - Aged, 80 and over
MH  - Analysis of Variance
MH  - Angioplasty, Balloon, Coronary/adverse effects/*methods
MH  - Cohort Studies
MH  - Coronary Angiography/methods
MH  - Coronary Restenosis/diagnostic imaging/epidemiology
MH  - Coronary Stenosis/diagnostic imaging/mortality/*therapy
MH  - *Drug-Eluting Stents
MH  - Electrocardiography/methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prosthesis Failure
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Sex Factors
MH  - Sirolimus/*analogs & derivatives/pharmacology
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2012/06/12 06:00
MHDA- 2012/11/07 06:00
CRDT- 2012/06/12 06:00
PHST- 2012/06/12 06:00 [entrez]
PHST- 2012/06/12 06:00 [pubmed]
PHST- 2012/11/07 06:00 [medline]
PST - ppublish
SO  - J Invasive Cardiol. 2012 Jun;24(6):256-60.