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 Giuseppe 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 journalArticle

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)1890-901
Number of pages12
JournalJACC: Cardiovascular Interventions
Volume9
Issue number18
DOIs
Publication statusPublished - Sep 26 2016

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Drug-Eluting Stents
Percutaneous Coronary Intervention
Coronary Vessels
Myocardial Infarction
Stents
Thrombosis
Confidence Intervals
Hypercholesterolemia
Coronary Angiography
Left Ventricular Function
Coronary Artery Bypass
Smoking
Hypertension
Transplants
Kidney

Keywords

  • Journal Article

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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. / Giustino, Gennaro; Mastoris, Ioannis; Baber, Usman; Sartori, Samantha; Stone, Gregg W.; Leon, Martin B.; Serruys, Patrick W.; Kastrati, Adnan; Windecker, Stephan; Valgimigli, Marco; Dangas, George D.; Von Birgelen, Clemens; Smits, Pieter C.; Kandzari, David; Galatius, Soren; Wijns, William; Steg, P. Gabriel; Stefanini, Giulio Giuseppe; Aquino, Melissa; Morice, Marie Claude; Camenzind, Edoardo; Weisz, Giora; Jeger, Raban V.; Kimura, Takeshi; Mikhail, Ghada W.; Itchhaporia, Dipti; Mehta, Laxmi; Ortega, Rebecca; Kim, Hyo Soo; Chieffo, Alaide; Mehran, Roxana.

In: JACC: Cardiovascular Interventions, Vol. 9, No. 18, 26.09.2016, p. 1890-901.

Research output: Contribution to journalArticle

Giustino, G, Mastoris, I, Baber, U, Sartori, S, Stone, GW, Leon, MB, Serruys, PW, Kastrati, A, Windecker, S, Valgimigli, M, Dangas, GD, Von Birgelen, C, Smits, PC, Kandzari, D, Galatius, S, Wijns, W, Steg, PG, Stefanini, GG, Aquino, M, Morice, MC, Camenzind, E, Weisz, G, Jeger, RV, Kimura, T, Mikhail, GW, Itchhaporia, D, Mehta, L, Ortega, R, Kim, HS, Chieffo, A & Mehran, R 2016, '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', JACC: Cardiovascular Interventions, vol. 9, no. 18, pp. 1890-901. https://doi.org/10.1016/j.jcin.2016.06.022
Giustino, Gennaro ; Mastoris, Ioannis ; Baber, Usman ; Sartori, Samantha ; Stone, Gregg W. ; Leon, Martin B. ; Serruys, Patrick W. ; Kastrati, Adnan ; Windecker, Stephan ; Valgimigli, Marco ; Dangas, George D. ; Von Birgelen, Clemens ; Smits, Pieter C. ; Kandzari, David ; Galatius, Soren ; Wijns, William ; Steg, P. Gabriel ; Stefanini, Giulio Giuseppe ; Aquino, Melissa ; Morice, Marie Claude ; Camenzind, Edoardo ; Weisz, Giora ; Jeger, Raban V. ; Kimura, Takeshi ; Mikhail, Ghada W. ; Itchhaporia, Dipti ; Mehta, Laxmi ; Ortega, Rebecca ; Kim, Hyo Soo ; Chieffo, Alaide ; Mehran, Roxana. / 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. In: JACC: Cardiovascular Interventions. 2016 ; Vol. 9, No. 18. pp. 1890-901.
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title = "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",
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.",
keywords = "Journal Article",
author = "Gennaro Giustino and Ioannis Mastoris and Usman Baber and Samantha Sartori and Stone, {Gregg W.} and Leon, {Martin B.} and Serruys, {Patrick W.} and Adnan Kastrati and Stephan Windecker and Marco Valgimigli and Dangas, {George D.} and {Von Birgelen}, Clemens and Smits, {Pieter C.} and David Kandzari and Soren Galatius and William Wijns and Steg, {P. Gabriel} and Stefanini, {Giulio Giuseppe} and Melissa Aquino and Morice, {Marie Claude} and Edoardo Camenzind and Giora Weisz and Jeger, {Raban V.} and Takeshi Kimura and Mikhail, {Ghada W.} and Dipti Itchhaporia and Laxmi Mehta and Rebecca Ortega and Kim, {Hyo Soo} and Alaide Chieffo and Roxana Mehran",
note = "Copyright {\circledC} 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2016",
month = "9",
day = "26",
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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

AU - Galatius, Soren

AU - Wijns, William

AU - Steg, P. Gabriel

AU - Stefanini, Giulio Giuseppe

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

N1 - Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2016/9/26

Y1 - 2016/9/26

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 - Journal Article

U2 - 10.1016/j.jcin.2016.06.022

DO - 10.1016/j.jcin.2016.06.022

M3 - Article

C2 - 27659564

VL - 9

SP - 1890

EP - 1901

JO - JACC: Cardiovascular Interventions

JF - JACC: Cardiovascular Interventions

SN - 1936-8798

IS - 18

ER -