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.
KW - n/a OA procedure
U2 - 10.1016/j.jcin.2016.06.022
DO - 10.1016/j.jcin.2016.06.022
M3 - Article
SN - 1936-8798
VL - 9
SP - 1890
EP - 1901
JO - JACC : cardiovascular interventions
JF - JACC : cardiovascular interventions
IS - 18
ER -
