This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (50)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Men's Health  • Men's Health, Other  • Prognosis/ Outcomes  • Alert me on articles by topic  Social Bookmarking   What's this?

Julinda Mehilli, MD; Adnan Kastrati, MD; Josef Dirschinger, MD; Hildegard Bollwein, MD; Franz-Josef Neumann, MD; Albert Schömig, MD

JAMA. 2000;284:1799-1805.

Context  Women with coronary artery disease (CAD) are believed to have a higher risk for adverse outcomes than men after conventional coronary interventions. The increasing use of coronary stenting has improved the outcome of patients undergoing coronary interventions, but little is known about the nature of outcomes in men vs women after this procedure.

Objective  To examine whether there are sex-based differences in prognostic factors and in early and late outcomes among CAD patients undergoing coronary stent placement.

Design, Setting, and Patients  Inception cohort study, at 2 tertiary referral institutions in Germany. Consecutive series of 1001 women and 3263 men with symptomatic CAD who were treated with stenting between May 1992 and December 1998. Patients who underwent stenting in the setting of acute myocardial infarction were excluded.

Main Outcome Measure  The combined event rates of death and nonfatal myocardial infarction, assessed at 30 days and 1 year after stenting and compared by sex.

Results  Compared with men, women undergoing coronary stenting were significantly older (mean age, 69 vs 63 years) and more likely to present with diabetes, arterial hypertension, or hypercholesterolemia. Women had less extensive CAD, a less frequent history of myocardial infarction and better preserved left ventricular function than men. Women presented an excess risk of death or nonfatal myocardial infarction only during the early period after stenting: the 30-day combined event rate of death or myocardial infarction was 3.1% in women and 1.8% in men (P = .02) and the multivariate-adjusted hazard ratio (HR) for women was 2.02 (95% confidence interval [CI], 1.27-3.19). At 1 year, the outcome was similar for both women and men (combined event rate for women, 6.0%, and for men, 5.8% (P = .77); multivariate-adjusted HR for women, 1.06 [95% CI, 0.75-1.48]). There was a sex difference in the prognostic value of baseline characteristics: the strongest prognostic factors were diabetes in women and age in men.

Conclusions  The results of this study indicate that 1-year outcomes of women with CAD undergoing coronary artery stenting are similar to those of men. Despite the similarity in outcomes, there are several sex-specific differences in baseline characteristics, clinical course after the intervention, and relative weight of prognostic factors.

Author Affiliations: Deutsches Herzzentrum (Drs Mehilli, Kastrati, Dirschinger, Bollwein, and Schömig) and 1. Medizinische Klinik rechts der Isar (Drs Neumann and Schömig), Technische Universität, Munich, Germany.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Coronary Artery Stents
Jassim Al Suwaidi, Peter B. Berger, and David R. Holmes, Jr
JAMA. 2000;284(14):1828-1836.
ABSTRACT | FULL TEXT  

Stent Scrutiny
A. Michael Lincoff
JAMA. 2000;284(14):1839-1841.
EXTRACT | FULL TEXT  

October 11, 2000
JAMA. 2000;284(14):1863-1864.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Efficacy of Drug-Eluting Stents in Women: A Window of Opportunity
Jacobs
J Am Coll Cardiol Intv 2009;2:611-613.
FULL TEXT  

Quantitative Results of Baseline Angiography and Percutaneous Coronary Intervention in the COURAGE Trial
Mancini et al.
Circ Cardiovasc Qual Outcomes 2009;2:320-327.
ABSTRACT | FULL TEXT  

Coronary Intervention in 2009: Are Women No Different Than Men?
Jacobs
Circ Cardiovasc Interv 2009;2:69-78.
FULL TEXT  

Stent Thrombosis, Clinical Events, and Influence of Prolonged Clopidogrel Use After Placement of Drug-Eluting Stent: Data From an Observational Cohort Study of Drug-Eluting Versus Bare-Metal Stents
Park et al.
J Am Coll Cardiol Intv 2008;1:494-503.
ABSTRACT | FULL TEXT  

Mortality differences between men and women after percutaneous coronary interventions. A 25-year, single-center experience.
Singh et al.
J Am Coll Cardiol 2008;51:2313-2320.
ABSTRACT | FULL TEXT  

Gender-based differences in mechanisms of protection in myocardial ischemia-reperfusion injury
Murphy and Steenbergen
Cardiovasc Res 2007;75:478-486.
ABSTRACT | FULL TEXT  

Gender Differences in Hospital Mortality and Use of Percutaneous Coronary Intervention in Acute Myocardial Infarction: Microsimulation Analysis of the 1999 Nationwide French Hospitals Database
Milcent et al.
Circulation 2007;115:833-839.
ABSTRACT | FULL TEXT  

Retinal vascular calibre and the risk of coronary heart disease-related death
Wang et al.
Heart 2006;92:1583-1587.
ABSTRACT | FULL TEXT  

Insights From the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part II: Gender Differences in Presentation, Diagnosis, and Outcome With Regard to Gender-Based Pathophysiology of Atherosclerosis and Macrovascular and Microvascular Coronary Disease
Bairey Merz et al.
J Am Coll Cardiol 2006;47:S21-S29.
ABSTRACT | FULL TEXT  

Women, Ischemic Heart Disease, Revascularization, and the Gender Gap: What Are We Missing?
Jacobs
J Am Coll Cardiol 2006;47:S63-S65.
ABSTRACT | FULL TEXT  

Percutaneous Coronary Intervention and Adjunctive Pharmacotherapy in Women: A Statement for Healthcare Professionals From the American Heart Association
Lansky et al.
Circulation 2005;111:940-953.
ABSTRACT | FULL TEXT  

Is aspirin resistance or female gender associated with a high incidence of myonecrosis after nonurgent percutaneous coronary intervention? Reply
Chen et al.
J Am Coll Cardiol 2005;45:636-636.
FULL TEXT  

Sirolimus-Eluting vs Uncoated Stents for Prevention of Restenosis in Small Coronary Arteries: A Randomized Trial
Ardissino et al.
JAMA 2004;292:2727-2734.
ABSTRACT | FULL TEXT  

A 69-Year-Old Woman With Left Main Coronary Artery Disease
Carrozza and Sellke
JAMA 2004;292:2506-2514.
FULL TEXT  

Do men benefit more than women from an interventional strategy in patients with unstable angina or non-ST-elevation myocardial infarction? The impact of gender in the RITA 3 trial
Clayton et al.
Eur Heart J 2004;25:1641-1650.
ABSTRACT | FULL TEXT  

One-Year Clinical Results With the Slow-Release, Polymer-Based, Paclitaxel-Eluting TAXUS Stent: The TAXUS-IV Trial
Stone et al.
Circulation 2004;109:1942-1947.
ABSTRACT | FULL TEXT  

Women's Ischemic Syndrome Evaluation: Current Status and Future Research Directions: Report of the National Heart, Lung and Blood Institute Workshop*: October 2-4, 2002 : Executive Summary
Bairey Merz et al.
Circulation 2004;109:805-807.
FULL TEXT  

Gender and restenosis after coronary artery stenting
Mehilli et al.
Eur Heart J 2003;24:1523-1530.
ABSTRACT | FULL TEXT  

Relationship of Peripheral Arterial Compliance and Standard Cardiovascular Risk Factors
Willens et al.
VASC ENDOVASCULAR SURG 2003;37:197-206.
ABSTRACT  

Is glycoprotein IIb/IIIa antagonism as effective in women as in men following percutaneous coronary intervention?: Lessons from the ESPRIT study
Fernandes et al.
J Am Coll Cardiol 2002;40:1085-1091.
ABSTRACT | FULL TEXT  

Application of Ex Vivo Flow Chamber System for Assessment of Stent Thrombosis
Sakakibara et al.
Arterioscler. Thromb. Vasc. Bio. 2002;22:1360-1364.
ABSTRACT | FULL TEXT  

Retinal Arteriolar Narrowing and Risk of Coronary Heart Disease in Men and Women: The Atherosclerosis Risk in Communities Study
Wong et al.
JAMA 2002;287:1153-1159.
ABSTRACT | FULL TEXT  

Clinical characteristics of coronary heart disease in women: emphasis on gender differences
Wenger
Cardiovasc Res 2002;53:558-567.
FULL TEXT  

Sex-Based Analysis of Outcome in Patients With Acute Myocardial Infarction Treated Predominantly With Percutaneous Coronary Intervention
Mehilli et al.
JAMA 2002;287:210-215.
ABSTRACT | FULL TEXT  

Similar 1-Year Outcomes for Women and Men After Coronary Artery Stenting
JWatch Women's Health 2000;2000:13-13.
FULL TEXT  

Similar 1-Year Outcomes for Women and Men After Coronary Artery Stenting
Journal Watch Cardiology 2000;2000:1-1.
FULL TEXT  

Stent Scrutiny
Lincoff
JAMA 2000;284:1839-1841.
FULL TEXT