Correlates and Impact of Coronary Artery Calcifications in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents: From the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration

Gennaro Giustino, Ioannis Mastoris, Usman Baber, Samantha Sartori, Gregg W. Stone, Martin B. Leon, Patrick W. Serruys, Adnan Kastrati, Stephan Windecker, Marco Valgimigli, George D. Dangas, Clemens von Birgelen, Pieter C. Smits, David E. Kandzari, Soren Galatius, William Wijns, Gabriel Steg, Giulio G. Stefanini, Melissa Aquino, Marie-Claude Morice & 11 others Edoardo Camenzind, Giora Weisz, Raban V. Jeger, Takeshi Kimura, Ghada W. Mikhail, Dipti Itchhaporia, Laxmi Mehta, Rebecca Ortega, Hyo-Soo Kim, Alaide Chieffo, Roxana Mehran

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

Objectives: The aim of this study was to investigate the clinical correlates and prognostic impact of coronary artery calcification (CAC) in women undergoing percutaneous coronary intervention with drug-eluting stents (DES).

Background: The clinical correlates and the prognostic significance of CAC in women undergoing percutaneous coronary intervention with DES remain unclear.

Methods: Patient-level data from female participants in 26 randomized trials of DES were pooled. Study population was categorized according to the presence of moderate or severe versus mild or no target lesion CAC, assessed through coronary angiography. Co–primary endpoints of interest were the composite of death, myocardial infarction (MI), or target lesion revascularization and death, MI, or stent thrombosis at 3-year follow-up.

Results: Among 11,557 women included in the pooled dataset, CAC status was available in 6,371 women. Of these, 1,622 (25.5%) had moderate or severe CAC. In fully adjusted models, independent correlates of CAC were age, hypertension, hypercholesterolemia, smoking, previous coronary artery bypass graft surgery, and worse left ventricular and renal function. At 3 years, women with CAC were at higher risk for death, MI, or target lesion revascularization (18.2% vs. 13.1%; adjusted hazard ratio: 1.56; 95% confidence interval: 1.33 to 1.84; p < 0.0001) and death, MI, or stent thrombosis (12.7% vs. 8.6%; adjusted hazard ratio: 1.48; 95% confidence interval: 1.21 to 1.80; p = 0.0001). The adverse effect of CAC on ischemic outcomes appeared to be consistent across clinical and angiographic subsets of women, including new-generation DES.

Conclusions: Women undergoing PCI of calcified lesions tend to have worse clinical profile and remain at increased ischemic risk, irrespective of new-generation DES.

Original languageEnglish
Pages (from-to)1890-1901
JournalJACC : cardiovascular interventions
Volume9
Issue number18
DOIs
Publication statusPublished - 2016

Fingerprint

Drug-Eluting Stents
Percutaneous Coronary Intervention
Coronary Vessels
Myocardial Infarction
Stents
Thrombosis
Confidence Intervals
Hypercholesterolemia
Coronary Angiography
Left Ventricular Function
Coronary Artery Bypass
Smoking
Hypertension
Transplants
Kidney

Cite this

Giustino, Gennaro ; Mastoris, Ioannis ; Baber, Usman ; Sartori, Samantha ; Stone, Gregg W. ; Leon, Martin B. ; Serruys, Patrick W. ; Kastrati, Adnan ; Windecker, Stephan ; Valgimigli, Marco ; Dangas, George D. ; von Birgelen, Clemens ; Smits, Pieter C. ; Kandzari, David E. ; Galatius, Soren ; Wijns, William ; Steg, Gabriel ; Stefanini, Giulio G. ; Aquino, Melissa ; Morice, Marie-Claude ; Camenzind, Edoardo ; Weisz, Giora ; Jeger, Raban V. ; Kimura, Takeshi ; Mikhail, Ghada W. ; Itchhaporia, Dipti ; Mehta, Laxmi ; Ortega, Rebecca ; Kim, Hyo-Soo ; Chieffo, Alaide ; Mehran, Roxana. / Correlates and Impact of Coronary Artery Calcifications in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents : From the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration. In: JACC : cardiovascular interventions. 2016 ; Vol. 9, No. 18. pp. 1890-1901.
@article{167006e0b9dc4c4d98f37f11d817b7b1,
title = "Correlates and Impact of Coronary Artery Calcifications in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents: From the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration",
abstract = "Objectives: The aim of this study was to investigate the clinical correlates and prognostic impact of coronary artery calcification (CAC) in women undergoing percutaneous coronary intervention with drug-eluting stents (DES).Background: The clinical correlates and the prognostic significance of CAC in women undergoing percutaneous coronary intervention with DES remain unclear.Methods: Patient-level data from female participants in 26 randomized trials of DES were pooled. Study population was categorized according to the presence of moderate or severe versus mild or no target lesion CAC, assessed through coronary angiography. Co–primary endpoints of interest were the composite of death, myocardial infarction (MI), or target lesion revascularization and death, MI, or stent thrombosis at 3-year follow-up.Results: Among 11,557 women included in the pooled dataset, CAC status was available in 6,371 women. Of these, 1,622 (25.5{\%}) had moderate or severe CAC. In fully adjusted models, independent correlates of CAC were age, hypertension, hypercholesterolemia, smoking, previous coronary artery bypass graft surgery, and worse left ventricular and renal function. At 3 years, women with CAC were at higher risk for death, MI, or target lesion revascularization (18.2{\%} vs. 13.1{\%}; adjusted hazard ratio: 1.56; 95{\%} confidence interval: 1.33 to 1.84; p < 0.0001) and death, MI, or stent thrombosis (12.7{\%} vs. 8.6{\%}; adjusted hazard ratio: 1.48; 95{\%} confidence interval: 1.21 to 1.80; p = 0.0001). The adverse effect of CAC on ischemic outcomes appeared to be consistent across clinical and angiographic subsets of women, including new-generation DES.Conclusions: Women undergoing PCI of calcified lesions tend to have worse clinical profile and remain at increased ischemic risk, irrespective of new-generation DES.",
author = "Gennaro Giustino and Ioannis Mastoris and Usman Baber and Samantha Sartori and Stone, {Gregg W.} and Leon, {Martin B.} and Serruys, {Patrick W.} and Adnan Kastrati and Stephan Windecker and Marco Valgimigli and Dangas, {George D.} and {von Birgelen}, Clemens and Smits, {Pieter C.} and Kandzari, {David E.} and Soren Galatius and William Wijns and Gabriel Steg and Stefanini, {Giulio G.} and Melissa Aquino and Marie-Claude Morice and Edoardo Camenzind and Giora Weisz and Jeger, {Raban V.} and Takeshi Kimura and Mikhail, {Ghada W.} and Dipti Itchhaporia and Laxmi Mehta and Rebecca Ortega and Hyo-Soo Kim and Alaide Chieffo and Roxana Mehran",
year = "2016",
doi = "10.1016/j.jcin.2016.06.022",
language = "English",
volume = "9",
pages = "1890--1901",
journal = "JACC : cardiovascular interventions",
issn = "1936-8798",
publisher = "Elsevier",
number = "18",

}

Giustino, G, Mastoris, I, Baber, U, Sartori, S, Stone, GW, Leon, MB, Serruys, PW, Kastrati, A, Windecker, S, Valgimigli, M, Dangas, GD, von Birgelen, C, Smits, PC, Kandzari, DE, Galatius, S, Wijns, W, Steg, G, Stefanini, GG, Aquino, M, Morice, M-C, Camenzind, E, Weisz, G, Jeger, RV, Kimura, T, Mikhail, GW, Itchhaporia, D, Mehta, L, Ortega, R, Kim, H-S, Chieffo, A & Mehran, R 2016, 'Correlates and Impact of Coronary Artery Calcifications in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents: From the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration' JACC : cardiovascular interventions, vol. 9, no. 18, pp. 1890-1901. https://doi.org/10.1016/j.jcin.2016.06.022

Correlates and Impact of Coronary Artery Calcifications in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents : From the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration. / Giustino, Gennaro; Mastoris, Ioannis; Baber, Usman; Sartori, Samantha; Stone, Gregg W.; Leon, Martin B.; Serruys, Patrick W.; Kastrati, Adnan; Windecker, Stephan; Valgimigli, Marco; Dangas, George D.; von Birgelen, Clemens; Smits, Pieter C.; Kandzari, David E.; Galatius, Soren; Wijns, William; Steg, Gabriel; Stefanini, Giulio G.; Aquino, Melissa; Morice, Marie-Claude; Camenzind, Edoardo; Weisz, Giora; Jeger, Raban V.; Kimura, Takeshi; Mikhail, Ghada W.; Itchhaporia, Dipti; Mehta, Laxmi; Ortega, Rebecca; Kim, Hyo-Soo; Chieffo, Alaide; Mehran, Roxana.

In: JACC : cardiovascular interventions, Vol. 9, No. 18, 2016, p. 1890-1901.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Correlates and Impact of Coronary Artery Calcifications in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents

T2 - From the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration

AU - Giustino, Gennaro

AU - Mastoris, Ioannis

AU - Baber, Usman

AU - Sartori, Samantha

AU - Stone, Gregg W.

AU - Leon, Martin B.

AU - Serruys, Patrick W.

AU - Kastrati, Adnan

AU - Windecker, Stephan

AU - Valgimigli, Marco

AU - Dangas, George D.

AU - von Birgelen, Clemens

AU - Smits, Pieter C.

AU - Kandzari, David E.

AU - Galatius, Soren

AU - Wijns, William

AU - Steg, Gabriel

AU - Stefanini, Giulio G.

AU - Aquino, Melissa

AU - Morice, Marie-Claude

AU - Camenzind, Edoardo

AU - Weisz, Giora

AU - Jeger, Raban V.

AU - Kimura, Takeshi

AU - Mikhail, Ghada W.

AU - Itchhaporia, Dipti

AU - Mehta, Laxmi

AU - Ortega, Rebecca

AU - Kim, Hyo-Soo

AU - Chieffo, Alaide

AU - Mehran, Roxana

PY - 2016

Y1 - 2016

N2 - Objectives: The aim of this study was to investigate the clinical correlates and prognostic impact of coronary artery calcification (CAC) in women undergoing percutaneous coronary intervention with drug-eluting stents (DES).Background: The clinical correlates and the prognostic significance of CAC in women undergoing percutaneous coronary intervention with DES remain unclear.Methods: Patient-level data from female participants in 26 randomized trials of DES were pooled. Study population was categorized according to the presence of moderate or severe versus mild or no target lesion CAC, assessed through coronary angiography. Co–primary endpoints of interest were the composite of death, myocardial infarction (MI), or target lesion revascularization and death, MI, or stent thrombosis at 3-year follow-up.Results: Among 11,557 women included in the pooled dataset, CAC status was available in 6,371 women. Of these, 1,622 (25.5%) had moderate or severe CAC. In fully adjusted models, independent correlates of CAC were age, hypertension, hypercholesterolemia, smoking, previous coronary artery bypass graft surgery, and worse left ventricular and renal function. At 3 years, women with CAC were at higher risk for death, MI, or target lesion revascularization (18.2% vs. 13.1%; adjusted hazard ratio: 1.56; 95% confidence interval: 1.33 to 1.84; p < 0.0001) and death, MI, or stent thrombosis (12.7% vs. 8.6%; adjusted hazard ratio: 1.48; 95% confidence interval: 1.21 to 1.80; p = 0.0001). The adverse effect of CAC on ischemic outcomes appeared to be consistent across clinical and angiographic subsets of women, including new-generation DES.Conclusions: Women undergoing PCI of calcified lesions tend to have worse clinical profile and remain at increased ischemic risk, irrespective of new-generation DES.

AB - Objectives: The aim of this study was to investigate the clinical correlates and prognostic impact of coronary artery calcification (CAC) in women undergoing percutaneous coronary intervention with drug-eluting stents (DES).Background: The clinical correlates and the prognostic significance of CAC in women undergoing percutaneous coronary intervention with DES remain unclear.Methods: Patient-level data from female participants in 26 randomized trials of DES were pooled. Study population was categorized according to the presence of moderate or severe versus mild or no target lesion CAC, assessed through coronary angiography. Co–primary endpoints of interest were the composite of death, myocardial infarction (MI), or target lesion revascularization and death, MI, or stent thrombosis at 3-year follow-up.Results: Among 11,557 women included in the pooled dataset, CAC status was available in 6,371 women. Of these, 1,622 (25.5%) had moderate or severe CAC. In fully adjusted models, independent correlates of CAC were age, hypertension, hypercholesterolemia, smoking, previous coronary artery bypass graft surgery, and worse left ventricular and renal function. At 3 years, women with CAC were at higher risk for death, MI, or target lesion revascularization (18.2% vs. 13.1%; adjusted hazard ratio: 1.56; 95% confidence interval: 1.33 to 1.84; p < 0.0001) and death, MI, or stent thrombosis (12.7% vs. 8.6%; adjusted hazard ratio: 1.48; 95% confidence interval: 1.21 to 1.80; p = 0.0001). The adverse effect of CAC on ischemic outcomes appeared to be consistent across clinical and angiographic subsets of women, including new-generation DES.Conclusions: Women undergoing PCI of calcified lesions tend to have worse clinical profile and remain at increased ischemic risk, irrespective of new-generation DES.

U2 - 10.1016/j.jcin.2016.06.022

DO - 10.1016/j.jcin.2016.06.022

M3 - Article

VL - 9

SP - 1890

EP - 1901

JO - JACC : cardiovascular interventions

JF - JACC : cardiovascular interventions

SN - 1936-8798

IS - 18

ER -