Gender differences and bleeding complications after PCI on first and second generation DES

Wańha, Wojciech; Kawecki, Damian; Roleder, Tomasz; Pluta, Aleksandra; Marcinkiewicz, Kamil; Morawiec, Beata; Kret, Mariska E.; Pawłowski, Tomasz; Smołka, Grzegorz; Ochała, Andrzej; Wojakowski, Wojciech

doi:10.1080/14017431.2016.1219044

Cited by 6 publications

(3 citation statements)

References 23 publications

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“… 36 Wanha et al also found that although the 1-year bleeding risk between females and males was similar after PCI therapy, females experienced a higher risk of in-hospital bleeding events. 37 Extending prior reports, the current study was also focused on elucidating the factors associated with the gender-disparities in bleeding events. As presented in Table 4 , ageing, diabetes mellitus and glycoprotein IIb/IIIa inhibitor use at peri-PCI period were associated with the gender-disparities in the composite bleeding events.…”

Section: Discussionmentioning

confidence: 99%

Gender-Disparities in the in-Hospital Clinical Outcome Among Patients with Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention

Wang¹,

S²,

Mo³

et al. 2022

IJGM

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Purpose The current study was to evaluate the gender-disparities in the in-hospital thrombotic and bleeding events among patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI). Patients and Methods Patients with CKD undergoing PCI were retrospectively enrolled. Baseline characteristics, and thrombotic and bleeding events occurred during hospitalization were collected and compared by gender. Results Compared to males (n = 558), females (n = 402) were older and more likely to have diabetes mellitus (37.1% vs 29.7%). Females had a lower estimated glomerular filtration rate (eGFR; 51.2 ± 7.9 vs 54.6 ± 5.1 mL/min/1.73m 2 ) and were more likely to undergo urgent PCI (66.7% vs 60.2%) and use glycoprotein IIb/IIIa inhibitor (15.4% vs 7.5%) at peri-PCI period. Compared to males, females had a higher rate of in-hospital mortality which was due to thrombotic events (9.0% vs 3.4%). Females also had a higher rate of moderate-to-severe hemorrhage (8.0% vs 3.2%). After multivariable adjustment, diabetes mellitus (odds ratio [OR] 1.15 and 95% confidence interval [CI] 1.07–1.29) and acute coronary syndrome (ACS) presentation (OR 1.53 and 95% CI 1.34–1.93) were associated with gender-disparities in composite thrombotic events. Ageing (OR 1.10 and 95% CI 1.02–1.33), diabetes mellitus (OR 1.21 and 95% CI 1.07–1.40) and glycoprotein IIb/IIIa inhibitor use (OR 1.13 and 95% CI 1.02–1.28) were associated with composite bleeding events. Conclusion Females with CKD undergoing PCI had a higher risk of experiencing in-hospital thrombotic and bleeding events than males.

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Section: Discussionmentioning

confidence: 99%

Gender-Disparities in the in-Hospital Clinical Outcome Among Patients with Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention

Wang¹,

S²,

Mo³

et al. 2022

IJGM

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“…Despite the undeniable development of stent technology and the undisputed revolution linked with the introduction to the clinical practice of second-generation DES 25 still, the diabetes population seems to have a faint advantage from this novel technology 26,27 Several conceptional improvements in stent design and modality had been postulated and introduced to clinical practice to overcome these limitations. 28,29 Especially high expectations had been associated with bioresorbable materials [30][31][32] -two different concepts have been proposed to use the advantage of these novel materials.…”

Section: Discussionmentioning

confidence: 99%

Mid-term safety and efficacy of magnesium bioresorbable vascular scaffolds – magmaris in diabetic population. 2-Years outcome in acute coronary syndrome cohort

Włodarczak

Rola

Barycki

et al. 2023

Diabetes and Vascular Disease Research

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Background Diabetes type 2 is one of the strongest risk factors affecting coronary artery disease (CAD) and is also a marker of poor short and long-term prognosis in subjects with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI) with subsequent drug-eluting stent (DES) implantation. Chronic local vascular inflammation along with endothelial dysfunction is postulated to be the pathophysiological background of unfavorable results. The second generation of metallic magnesium BRS –Magmaris (Biotronik, Berlin, Germany) had been introduced to clinical practice to overcome these limitations. Methods We evaluated 2-years clinical outcomes after Magmaris BRS implantation in NSTE-ACS diabetic ( n-72) and non-diabetic ( n-121) cohorts. Results No significant differences between diabetic and non-diabetes cohorts were noticed in terms of Primary Outcome (cardiac death, myocardial infarction, stent thrombosis) (8.1% vs 3.3% p = 0.182) and Principal secondary outcome – TLF- target lesion failure (9.5% vs 3.3% p = 0.106) at 2-years follow-up. Conclusions 2-years outcome suggests good safety and efficacy of the magnesium BRS (Magmaris) in NSTE- ACS and concomitant DM. Nevertheless, there is a strong need for large multicenter, randomized, prospective studies for a full assessment of this novel device in diabetic patients with ACS.

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“…28 Interestingly, the distribution of ARC-HBR criteria between females and males in our study was also different, which essentially reflects the sex-related dissimilarities in the burden of clinical comorbidities. 29 HBR females had a higher prevalence of CKD and moderate/severe anemia, 2 conditions that often occur concomitantly. By contrast, males were more frequently discharged on oral anticoagulant therapy.…”

Section: Discussionmentioning

confidence: 99%

Sex-Related Differences in the Prevalence and Prognostic Value of the Academic Research Consortium for High Bleeding Risk Criteria

Nardin

Cao

Mehran

et al. 2021

Circ: Cardiovascular Interventions

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Background: Bleeding events after percutaneous coronary intervention are associated with substantial morbidity and mortality. Female patients undergoing percutaneous coronary intervention are often older and present with a higher burden of comorbidities, which in turn increases their risk of adverse events, including bleeding complications. The Academic Research Consortium (ARC) have proposed a list of clinical criteria to define high bleeding risk (HBR). Our aim was to evaluate the prevalence and predictive value of the ARC-HBR criteria according to sex in a contemporary cohort of patients undergoing percutaneous coronary intervention. Methods: All consecutive patients receiving coronary stenting between 2014 and 2017 at a tertiary-care center were defined as HBR if they fulfilled at least 1 major or 2 minor ARC-HBR criteria. The primary bleeding end point was the composite of periprocedural in-hospital or postdischarge bleeding up to 1 year. Individual components of the primary bleeding end point, all-cause mortality, and myocardial infarction were also evaluated. Results: Of the total 9623 patients, 6979 (72.5%) were male and 2644 (27.5%) female. The prevalence of HBR was significantly higher in females compared with males (56.5% versus 39.9%, P <0.001). With regard to the individual criteria, moderate/severe anemia and moderate chronic kidney disease were more common in females, while oral anticoagulation and mild anemia were more frequent among males. The presence of HBR was associated with an increased risk of bleeding in both females (10.0% versus 4.4%; hazard ratio, 2.57 [95% CI, 1.80–3.67]; P <0.001) and males (8.7% versus 2.9%; hazard ratio, 3.19 [95% CI, 2.50–4.08]; P <0.001)(p interaction =0.344).The ARC-HBR criteria associated with the highest bleeding risk at 1 year were severe/end-stage chronic kidney disease and thrombocytopenia in females, and moderate/severe anemia in males. Conclusions: In a real-world cohort of percutaneous coronary intervention patients, females were more often at HBR than males. The prognostic value of the ARC-HBR definition was consistent between female and male patients, despite sex-related differences in the prevalence and bleeding risk associated with individual ARC-HBR criteria.

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Gender differences and bleeding complications after PCI on first and second generation DES

Abstract: Despite higher risk profile, women treated with DES have similar outcomes as males in 1-year follow-up. However there is, an increased risk of in-hospital bleedings in women.

Cited by 6 publications

References 23 publications

Gender-Disparities in the in-Hospital Clinical Outcome Among Patients with Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention

Gender-Disparities in the in-Hospital Clinical Outcome Among Patients with Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention

Mid-term safety and efficacy of magnesium bioresorbable vascular scaffolds – magmaris in diabetic population. 2-Years outcome in acute coronary syndrome cohort

Sex-Related Differences in the Prevalence and Prognostic Value of the Academic Research Consortium for High Bleeding Risk Criteria

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