Journal Article

Gender and restenosis after coronary artery stenting

Julinda Mehilli, Adnan Kastrati, Hildegard Bollwein, Alban Dibra, Helmut Schühlen, Josef Dirschinger and Albert Schömig

in European Heart Journal

Published on behalf of European Society of Cardiology

Volume 24, issue 16, pages 1523-1530
Published in print August 2003 | ISSN: 0195-668x
Published online August 2003 | e-ISSN: 1522-9645 | DOI:
Gender and restenosis after coronary artery stenting

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Aims To examine the impact of sex on restenosis in a large cohort of consecutive patients undergoing coronary stenting and systematic angiographic and clinical follow-up.

Methods and results The study includes a cohort of 4374 consecutive patients (1025 women and 3349 men), undergoing coronary stenting for stable or unstable angina. Follow-up angiography at 6 months was performed in 80% of patients. Clinical events were assessed for a period of 1 year after the procedure. Main end-points of the study were angiographic and clinical restenosis at follow-up. Compared to men, women were older, presented more often with diabetes, smaller vessel size and shorter lesions. Clinical restenosis (need for reintervention) was found in 14.8% of women and 17.5% of men (P=0.048). The incidence of angiographic restenosis was significantly lower in women then in men (28.9% vs 33.9%, respectively, P=0.01). After adjustment for other covariates, women presented a 23% reduction of the risk of restenosis: odds ratio 0.77 (95% confidence interval 0.63 to 0.93). While a small vessel size was a risk factor for restenosis in both sexes, the influence of diabetes on restenosis was mostly confined to women.

Conclusion Compared with men, women present a lower risk of restenosis after coronary stenting despite a more preponderant presence of two major risk factors for restenosis, diabetes and small vessel size. There are sex-based differences in predictive factors of restenosis with diabetes having a particularly strong impact in women.

Keywords: Coronary artery disease; Gender; Restenosis; Stents

Journal Article.  4089 words.  Illustrated.

Subjects: Cardiovascular Medicine

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