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 Kandzari, Soren Galatius, William Wijns, P. Gabriel Steg, Giulio G. Stefanini, Melissa Aquino, Marie Claude MoriceEdoardo 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 journalArticlepeer-review

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
Number of pages12
JournalJACC: Cardiovascular Interventions
Volume9
Issue number18
DOIs
Publication statusPublished - Sep 26 2016

Keywords

  • coronary artery calcifications
  • DES
  • PCI
  • women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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