A Sex-Based Analysis from the RAIN-CARDIOGROUP VII Study (VeRy Thin Stents for Patients with Left MAIn or BifurcatioN in Real Life) on Left Main Stenting

Daniela Trabattoni, Sebastiano Gili, Giovanni Teruzzi, Pierluigi Omedè, Enrico Cerrato, Christian Templin, Davide Capodanno, Thomas Lüscher, Nicola Ryan, Giuseppe Venuti, Andrea Montabone, Wojciech Wojakowski, Andrea Rognoni, Gerard Helft, Diego Gallo, Carlo Alberto Biolè, Radoslaw Parma, Leonardo De Luca, Filippo Figini, Satoru MitomoAlessio Mattesini, Giacomo Boccuzzi, Giorgio Quadri, Wojciech Wanha, Grzegorz Smolka, Zenon Huczek, Alaide Chieffo, Ivan Nuñez-Gil, Umberto Morbiducci, Mario Iannaccone, Carlo Di Mario, Claudio Moretti, Maurizio D'Amico, Imad Sheiban, Javier Escaned, Fabrizio D'Ascenzo

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction. There is a lack of data on clinical outcomes of percutaneous coronary intervention (PCI) with ultrathin stents on unprotected left main (ULM) coronary artery comparing women and men. Methods. All patients treated with ULM-PCI with ultrathin stents (struts ≤81 μm) enrolled in the RAIN-CARDIOGROUP VII study were analyzed according to a sex-assessment evaluation. Major adverse cardiovascular event (MACE, a composite of all-cause death, myocardial infarction, target-lesion revascularization [TLR], and stent thrombosis) was the primary endpoint, whereas single components of MACE were the secondary endpoints. Results. Out of a cohort of 793 patients, a total of 172 women (21.7%) and 621 men (78.3%) were included. Compared with men, women were older and less frequently smokers, had more frequently a history of previous PCI, and presented more frequently with an acute coronary syndrome. Among women, ostial lesions were more prevalent and mean stent diameter was lower compared with men. After 13.4 months (range, 8.4-21.6 months), 32 women (18.6%) and 106 men (17.1%) experienced MACE (P=.64). Censoring follow-up data at 3 years, no differences were observed in MACE (16.9 vs 14.7 per 100•patient-years; log-rank P=.61) and their single components between women and men. At multivariate analysis, chronic kidney disease (hazard ratio [HR], 1.91: 95% confidence interval [CI], 1.23 to-2.95; P<.01) and acute coronary syndrome presentation (HR, 1.84; 95% CI, 1.22-2.77; P=.01) were independent predictors of MACE overall. Larger stent size (HR, 0.65; 95% CI, 0.48-0.89; P<.01) and longer dual-antiplatelet therapy duration (HR, 0.95; 95% CI, 0.90-0.99; P=.03) were associated with a reduced risk of MACE during the subsequent follow-up. Conclusion. Ultrathin stents offer low rates of MACE and TLR in the overall population without significant differences between sexes. J INVASIVE CARDIOL 2020;32(9):342-346. Epub 2020 June 22.

Original languageEnglish
Pages (from-to)342-346
Number of pages5
JournalJournal of Invasive Cardiology
Volume32
Issue number9
Publication statusPublished - Sep 2020

Keywords

  • Coronary artery disease
  • Drug-eluting stents
  • Gender medicine
  • Left main
  • Percutaneous coronary interventions

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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