Burcu Gul1, Ken Kozuma2, Ido Haimi1, Weiying Zhao3, Charles Simonton3, Shih-Wa Ying3, Alexandra Buda1, Sameer Mehta4, Andreas Baumbach1,5,6, Alexandra Lansky1,5,6. 1. Division of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut. 2. Division of Cardiovascular Medicine, Teikyo University, Tokyo, Japan. 3. Abbott Vascular, Santa Clara, California. 4. Lumen Global and LATIN, Miami, Florida. 5. Department of Cardiology, St Bartholomew's Hospital, London, United Kingdom. 6. William Harvey Research Institute and Queen Mary University of London, London, United Kingdom.
Abstract
AIM: We investigated sex-based and regional outcomes after contemporary percutaneous coronary intervention (PCI) with the Xience V stent in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: This patient level pooled analysis includes three multi-center, prospective post-market registries performed in the US, Japan, and China. A total of 1,938 patients treated with Xience V stents in the setting of AMI were enrolled. Compared to men, women had higher major adverse cardiac events (MACE) (14.1% vs. 9.8% P < 0.01, RR 1.4, 95% CI 1.1-1.4) and all-cause mortality (10% vs. 6.2% P < 0.01, RR 1.61, 95% CI 1.14-2.27) at one year, without any significant difference in device specific outcomes of target vessel failure (TVF). US patients compared to the patients from China and Japan had increased MACE (female: 18% vs. 7.1%, P = 0.0012, male: 15.7% vs. 4.1%, P < 0.0001). Multivariable analysis demonstrated that major bleeding was the strongest predictor of MACE (OR 10.51, 95%CI 4.01-27.50, P < 0.0001), MI (OR 4.26, 95%CI 1.37-13.29, P = 0.012), and all-cause death (OR 5.3, 95%CI 2.32-12.13, P < 0.0001). CONCLUSION: Women with AMI who underwent PCI with XIENCE DES have higher all-cause mortality at one year in compared to men. Region based outcomes demonstrated increased MACE among US patients compared to the patients from China and Japan. After adjusting for differences in demographics, major bleeding, rather than female sex, predicted the higher observed all-cause mortality.
AIM: We investigated sex-based and regional outcomes after contemporary percutaneous coronary intervention (PCI) with the Xience V stent in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: This patient level pooled analysis includes three multi-center, prospective post-market registries performed in the US, Japan, and China. A total of 1,938 patients treated with Xience V stents in the setting of AMI were enrolled. Compared to men, women had higher major adverse cardiac events (MACE) (14.1% vs. 9.8% P < 0.01, RR 1.4, 95% CI 1.1-1.4) and all-cause mortality (10% vs. 6.2% P < 0.01, RR 1.61, 95% CI 1.14-2.27) at one year, without any significant difference in device specific outcomes of target vessel failure (TVF). US patients compared to the patients from China and Japan had increased MACE (female: 18% vs. 7.1%, P = 0.0012, male: 15.7% vs. 4.1%, P < 0.0001). Multivariable analysis demonstrated that major bleeding was the strongest predictor of MACE (OR 10.51, 95%CI 4.01-27.50, P < 0.0001), MI (OR 4.26, 95%CI 1.37-13.29, P = 0.012), and all-cause death (OR 5.3, 95%CI 2.32-12.13, P < 0.0001). CONCLUSION:Women with AMI who underwent PCI with XIENCE DES have higher all-cause mortality at one year in compared to men. Region based outcomes demonstrated increased MACE among US patients compared to the patients from China and Japan. After adjusting for differences in demographics, major bleeding, rather than female sex, predicted the higher observed all-cause mortality.
Authors: Thomas J Ford; Adnan Khan; Kieran F Docherty; Alice Jackson; Andrew Morrow; Novalia Sidik; Paul Rocchiccioli; Richard Good; Hany Eteiba; Stuart Watkins; Aadil Shaukat; Mitchell Lindsay; Keith Robertson; Mark Petrie; Colin Berry; Keith G Oldroyd; Margaret McEntegart Journal: Catheter Cardiovasc Interv Date: 2019-07-01 Impact factor: 2.692
Authors: Jessica Potts; Alex Sirker; Sara C Martinez; Martha Gulati; Mirvat Alasnag; Muhammad Rashid; Chun Shing Kwok; Joie Ensor; Danielle L Burke; Richard D Riley; Lene Holmvang; Mamas A Mamas Journal: PLoS One Date: 2018-09-04 Impact factor: 3.240