Gender-based analysis of randomized comparison of bioactive versus everolimus-eluting stents in acute coronary syndrome. Issue 3 (March 2015)

• Record Type: Journal Article
• Authors: Sia, Jussi; Nammas, Wail; Niemelä, Matti; Airaksinen, Juhani K.E.; Lalmand, Jacques; Laine, Mika; Tedjokusumo, Pintoko; Nyman, Kai; Biancari, Fausto; Karjalainen, Pasi P.
• Is Part Of: Journal of cardiovascular medicine. Volume 16:Issue 3(2015:Mar.)
• Publication Date: 2015-03
• Subjects: Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000000086
• Languages: English
• ISSNs: 1558-2027

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Aims</title> <p>The randomized comparison of titanium-nitride-oxide-coated bioactive stent with everolimus-eluting stent in acute coronary syndrome (BASE-ACS) trial demonstrated an outcome of the titanium-nitride-oxide coated bioactive stents (BASs) that was statistically noninferior to that of the everolimus-eluting stents (EESs) at 12-month follow-up, in patients presenting with acute coronary syndrome (ACS) who underwent early percutaneous coronary intervention. We performed a post-hoc gender-based analysis of the BASE-ACS trial at 24-month follow-up.</p> </sec> <sec> <title>Methods</title> <p>A total of 827 patients (198 women) with ACS were randomly assigned to receive either BAS or EES. The primary endpoint was a composite of cardiac death, nonfatal myocardial infarction (MI), or ischemia-driven target lesion revascularization.</p> </sec> <sec> <title>Results</title> <p>Women were older, and more likely to have diabetes and hypertension compared with men (<italic>P</italic> < 0.05 for all). Moreover, women had significantly smaller reference vessel diameter and stent diameter (<italic>P</italic> < 0.05 for all). At 24-month follow-up, the cumulative incidence of the primary endpoint was similar between the two sex subgroups (15.2 versus 11.0%, for women versus men, respectively, <italic>P</italic> = 0.13). However, the rate of nonfatal MI was significantly higher in women compared with men (8.6 versus 3.8%, respectively, <italic>P</italic> = 0.007). After propensity score-adjusted analysis, there was a trend toward more nonfatal MI among women (8.6 versus 4.0%, respectively, <italic>P</italic> = 0.08). Moreover, among male patients, those assigned to BAS had significantly lower nonfatal MI compared with those assigned to EES (<italic>P</italic> = 0.027). However, among patients assigned to EES, female patients had a significantly higher rate of nonfatal MI compared with men (<italic>P</italic> = 0.02).</p> </sec> <sec> <title>Conclusion</title> <p>In the current post-hoc gender-based analysis of the BASE-ACS trial, the 24-month outcome of patients undergoing percutaneous coronary intervention for ACS was slightly worse in women, compared with men, as reflected by a trend toward more nonfatal MI events after propensity score-adjusted analysis.</p> </sec> </abstract>