Comparisons of the uptake and in-hospital outcomes associated with second-generation drug-eluting stents between men and women: results from the CathPCI Registry.

Abstract

We sought to examine trends in use and outcomes of second-generation drug-eluting stents (DES) across sexes in a contemporary percutaneous coronary intervention (PCI) cohort. Sparse female enrollment in trials comparing first-generation versus second-generation DES may influence clinical decision making at the time of PCI. We studied patients undergoing PCI with DES enrolled in the CathPCI Registry between July 2009 and March 2013. We compared the prevalence of second-generation DES use by sex over time. Outcomes included procedural success, post-PCI bleeding, and vascular complications. Associations between sex and DES type on outcomes were assessed using logistic regression with formal interaction tests. Compared with men (n=1 129 122; 67.7%), women (n=538 835; 32.3%) were older, with a higher prevalence of diabetes mellitus, peripheral vascular, and chronic kidney disease. Although use of second-generation DES increased among both men and women over time, use was higher among men in the first 1.5 years, with no differences thereafter. There were no differences in procedural success, bleeding, or vascular complications across sexes between first-generation and second-generation DES. Uptake of second-generation DES increased over time in women, with comparable in-hospital benefits as first-generation DES across sexes.