Gender-related differences of diabetic patients undergoing percutaneous coronary intervention with drug-eluting stents: A real-life multicenter experience

• Published in: International journal of cardiology Vol. 168; no. 1; pp. 139 - 143
• Main Authors: Buja, Paolo, D'Amico, Gianpiero, Facchin, Michela, Barioli, Alberto, Napodano, Massimo, Capodanno, Davide, Musumeci, Giuseppe, Frigo, Anna Chiara, Saia, Francesco, Menozzi, Alberto, De Benedictis, Mauro, Lee, Michael S, Lettieri, Corrado, Tamburino, Corrado, Sardella, Gennaro, Isabella, Giambattista, Tarantini, Giuseppe
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 20.09.2013; Elsevier
• Subjects: Aged; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular; Cohort Studies; Coronary heart disease; Diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - physiopathology; Diabetes Mellitus - surgery; Diabetes. Impaired glucose tolerance; Diseases of the cardiovascular system; Drug-Eluting Stents; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Gender; Heart; Humans; Male; Medical sciences; Middle Aged; Outcome; Percutaneous Coronary Intervention - methods; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Registries; Retrospective Studies; Sex Characteristics; Gender; Diabetes mellitus; Outcome; Drug-eluting stents; Endocrinopathy; Human; Atherectomy; Prognosis; Angioplasty; Multicenter study; Coronary artery; Sex; Instrumentation therapy; Patient; Cardiovascular disease; Coronary heart disease; Percutaneous route; Experience; Evolution; Cardiology; Drug eluting stent; Comparative study
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2012.09.049

Abstract Background Gender-based differences in diabetic patients are understudied in the field of percutaneous coronary intervention (PCI) with drug-eluting stents. Methods Data were obtained from a multicenter registry of 2420 consecutive patients with diabetes mellitus (DM) who underwent PCI with paclitaxel- or sirolimus-eluting stents between 2003 and 2009. Among them, 679 (28.1%) women were compared to 1741 (71.9%) men in terms of clinical aspects and major adverse cardiac events (MACE), including all-cause death, myocardial infarction (MI) and target lesion revascularization (TLR). Target vessel revascularization (TVR) and any revascularization were also reported. Results Women were less numerous, older, used more insulin and showed more tortuous coronary arteries, while men were more frequently smokers and received larger stents. At the median follow-up of 24.3 months (interquartile range 12.3–39.7), MACE, TVR and any revascularization did not significantly differ between females and males (19.9% vs 18.7%, 12.2% vs 13.4%, 14.1% vs 15.1%, respectively). At multivariable analysis of the overall cohort, female gender was not a predictor of MACE (hazard ratio [HR] 1.02, 95% confidence interval [CI] 0.92–2.36, p = 0.11), death (HR 1.04, 95% CI 0.84–1.24, p = 0.86), MI (HR 1.48, 95% CI 0.92–2.36, p = 0.11), and TLR (HR 1.14, 95% CI 0.85–1.52, p = 0.38). Conclusion In this registry of diabetic patients treated by drug-eluting stents, women were less represented, older and needed more insulin compared to men who, on the other hand, received larger stents. Gender-related outcomes were similar and female sex did not predict MACE.