Clinical Characteristics and Outcomes of Japanese Women Undergoing Coronary Revascularization Therapy

Furukawa, Yutaka; Ehara, Natsuhiko; Morimoto, Takeshi; Kaji, Shuichiro; Yamamuro, Atsushi; Kinoshita, Makoto; Kitai, Takeshi; Kim, Kitae; Tani, Tohru; Kobori, Atsushi; Nasu, Michihiro; Okada, Yukikatsu; Kita, Toru; Kimura, Takeshi; Investigators, The CREDO-Kyoto

doi:10.1253/circj.cj-10-0718

Cited by 24 publications

(26 citation statements)

References 35 publications

(12 reference statements)

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“…Recently, Funakoshi, et al reported the clinical outcomes of Japanese women from the CRE-DO-Kyoto registry with no significant gender difference in the incidence of MACE at 3-year follow-up. 25) The rates of allcause death and ACS among women in that registry were 8.8% and 3.4% at 3 years. The outcomes found in the present study of a high-risk diabetic population were similar to these, indicating that the clinical outcomes after PCI at our institution are acceptable.…”

Section: Discussionmentioning

confidence: 94%

Gender-Based Outcomes Among Patients With Diabetes Mellitus After Percutaneous Coronary Intervention in the Drug-Eluting Stent Era

et al. 2011

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SummaryDiabetes mellitus has a greater effect on mortality rates due to coronary artery disease in women than in men. Although women undergoing coronary intervention in general have a higher frequency of adverse outcomes than men, the effect of gender among diabetic patients on clinical outcomes after percutaneous coronary intervention (PCI) has not been well established in the drug-eluting stent (DES) era. We have investigated the impact of gender on long-term clinical outcome in these high risk populations. We enrolled 404 consecutive patients (74 women and 330 men) with diabetes mellitus who underwent elective PCI (85% with DES). We evaluated the incidence of major adverse cardiac events (MACE), which is a composite of total all-cause death, acute coronary syndrome (ACS), and target lesion revascularization (TLR) during a period of 4 years after coronary intervention. The women were significantly older, more likely to have dyslipidemia, and had significantly higher systolic blood pressure and LDL-C values than men. The use of insulin and angiotensin receptor blockers was more frequent among the women (32.4% versus 21.0%, P = 0.04 and 60.8% versus 39.8%, P < 0.01, respectively). The angiographic profiles of both were comparable. At four-year clinical follow-up, cumulative incidence of MACE was identical between the women and the men (16.2% versus 15.5%, P = 0.90; adjusted HR 1.23, 95% CI 0.61-2.50, P = 0.56). Although the baseline characteristics of the women were worse, clinical outcomes did not significantly differ between women and men among diabetic patients after elective PCI. (Int Heart J 2011; 52: 348-352) Key words: Gender, Diabetes mellitus, Cardiovascular disease, Coronary intervention, Drug-eluting stent P atients with diabetes mellitus (DM) have a higher incidence of cardiovascular disease (CVD) than the general population. 1,2) Diabetes has a greater effect on coronary artery disease (CAD) mortality rates among women than men. [3][4][5] Previous studies have demonstrated that diabetes mellitus is associated with accelerated development of atherosclerosis characterized by small vessels, long lesions, and a greater plaque burden. These findings have been attributed to worse outcomes after percutaneous coronary intervention (PCI) among patients with DM.6-8) Drug-eluting stents (DES) have remarkably reduced the incidence of restenosis compared with bare-metal stents (BMS) in randomized trials 9,10) and several studies have found a favorable clinical outcome of DES for patients with DM. 11,12) Gender differences were associated with presenting symptoms, method of diagnosis, baseline comorbidities, and outcomes of patients in the early period of balloon angioplasty. 13,14) Gender-based differences in outcomes after PCI narrowed after introduction of the BMS as well as DES, 15,16) and gender was not independently associated with adverse outcomes especially in low risk populations. However, gender differences among diabetic patients after PCI in the period of DES have not been fully elucidated. Therefore,...

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Section: Discussionmentioning

confidence: 94%

Gender-Based Outcomes Among Patients With Diabetes Mellitus After Percutaneous Coronary Intervention in the Drug-Eluting Stent Era

et al. 2011

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“…21 After adjustment for possible confounding factors, risks for mortality and MACE became comparable between the female and male AMI patients after primary PCI. This is also a distinctive finding compared with the result that the adjusted risk for mortality was significantly lower among female than male Japanese patients with stable CAD.…”

Section: Sex-based Differences In Long-term Outcomesmentioning

confidence: 94%

“…21 In the Kaplan-Meier analyses comparing any clinicallydriven and any non-clinically-driven coronary revascularization, TLR and non-TLR between the sexes clearly showed that the difference in the risk for any coronary revascularization risks were similar between the women and men (Table S3).…”

Section: Sex-based Differences In Long-term Outcomesmentioning

confidence: 95%

“…This is also a distinctive finding compared with the result that the adjusted risk for mortality was significantly lower among female than male Japanese patients with stable CAD. 21 The Kaplan-Meier curves indicate sex-based differences in all-cause and cardiovascular deaths, and in MACE, which derives from the higher rate of early mortality among the women. Thus, poorer early outcomes for women after AMI appear to account for the distinctive sexbased differences in long-term outcome.…”

Section: Sex-based Differences In Long-term Outcomesmentioning

confidence: 99%

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Sex-Based Differences in Clinical Practice and Outcomes for Japanese Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Takahashi

Furukawa

Ehara

et al. 2013

Circ J

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“…Finally, the cardiovascular event rates in the participants in the CREDO-Kyoto registry were lower than those in many other studies conducted outside Japan. 26 We should be careful in extrapolating the results of this study outside Japan.…”

Section: Study Limitationsmentioning

confidence: 95%

Distinct Survival Benefits of Angiotensin-Converting Enzyme Inhibitors/Angiotensin II Receptor Blockers in Revascularized Coronary Artery Disease Patients According to History of Myocardial Infarction

Nishino

Furukawa

Kaji

et al. 2013

Circ J

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Clinical Characteristics and Outcomes of Japanese Women Undergoing Coronary Revascularization Therapy

Cited by 24 publications

References 35 publications

Gender-Based Outcomes Among Patients With Diabetes Mellitus After Percutaneous Coronary Intervention in the Drug-Eluting Stent Era

Gender-Based Outcomes Among Patients With Diabetes Mellitus After Percutaneous Coronary Intervention in the Drug-Eluting Stent Era

Sex-Based Differences in Clinical Practice and Outcomes for Japanese Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Distinct Survival Benefits of Angiotensin-Converting Enzyme Inhibitors/Angiotensin II Receptor Blockers in Revascularized Coronary Artery Disease Patients According to History of Myocardial Infarction

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