Two-year clinical outcomes after coronary drug-eluting stent placement in Chinese men and women: a multicenter, prospective registry study

Rajiv Shrestha,¹ Sandeep Gami,¹ Jing Xu,² Du-Jiang Xie,² Zhi-Zhong Liu,² Tian Xu,¹ Fei Ye,² Shi-Qing Din,³ Xue-Song Qian,⁴ Song Yang,⁵ Yue-Qiang Liu,⁶ Feng Li,⁷ Ai-Ping Zhang,⁸ Shao-Liang Chen<sup>2

1</sup>Nanjing Medical University, Nanjing, ²Nanjing First Hospital, Nanjing Medical University, Nanjing, ³Huainan Xinhua Hospital, Huainan, ⁴Zhangjiagang People's Hospital, Zhangjiagang, ⁵Yixin People's Hospital, Yixin, ⁶Jintan People's Hospital, Jintan, ⁷Huainan Oriental General Hospital, Huainan, ⁸Huainan People's Hospital, Huainan, People's Republic of China

Background: Previous studies have reported a discrepancy in baseline characteristics and outcomes after percutaneous coronary intervention between men and women. However, this finding has never been verified in the Chinese population. The present study analyzed two-year clinical outcomes after placement of coronary drug-eluting stents in Chinese men and women.
Methods: From January 2005 to December 2010, a total of 3804 Chinese patients (2776 men, 1028 women) who underwent drug-eluting stent implantation were studied prospectively. The primary endpoint was the composite major adverse cardiac event (MACE) rate, including myocardial infarction, cardiac death, and target vessel revascularization at two years. Stent thrombosis served as the safety endpoint. Propensity score matching was used to compare the adjusted MACE rate between the two groups.
Results: At two-year follow-up, unadjusted rates of myocardial infarction, non-ST segment elevation myocardial infarction, target vessel revascularization, and MACE were significantly different between men (6.84%, 4.6%, 13.1%, and 21.7%, respectively) and women (3.8% [P = 0.001], 2.0% [P < 0.001] 10.3% [P = 0.025], and 16.3% [P < 0.001], respectively). After propensity score matching, there were no significant differences in composite MACE and individual endpoints at two years between the genders.
Conclusion: Despite all the unfavorable risk factor clustering in women and complex coronary disease in men, the two-year clinical outcomes after coronary stent placement were comparable between Chinese women and men.

Keywords: drug-eluting stent, major adverse cardiac event, gender difference, clinical follow-up