Comparison of the Effectiveness of Percutaneous Intervention of the Left-Main Coronary Artery With Everolimus-Eluting Stents in Women -Vs- Men
Description
Everolimus-eluting stents are largely used for left main (LM) percutaneous coronary interventions (PCI) . Long-term follow-up of patients undergoing LM PCI in a real world clinical setting, in particular women, have been scarcely reported. Consecutive patients undergoing unprotected LM PCI with EES at a single Institution from December 2006 to April 2016 were included. Main outcome assessed was the occurrence of major adverse cardiovascular events (MACE) as a composite of death, myocardial infarction or target lesion revascularization at follow-up. Overall, 589 patients (20.8% women), were included in the present analysis. Women were older, had lower BMI and more frequently hypertensive compared to men. Main clinical presentation was stable CAD; unstable angina was more frequently observed in women compared to men, whereas STEMI was less frequent. After 69.7 ± 28.3 months of follow-up, 47 patients overall experienced MACE (1.43 per 100*patients/year). MACE rate was higher in female compared to male patients, with a rate of 2.49 and 1.17 per 100*patients/year, respectively (P=0.015). The difference was driven mainly by higher mortality in women (0.89 vs. 0.15 per 100*patients/years, P=0.002). At multivariable Cox regression, female gender was independently associated with an increased risk of MACE at follow-up (HR 2.21, 95% CI 1.20 – 4.08, P=0.011). In conclusion, EES can be safely and effectively adopted for LM PCI