Resultados do implante de stent coronário eluidor de everolimus em mulheres latino-americanas

Abstract

Editorial Rev Bras Cardiol Invasiva. 2012;20(3):231-2 C oronary artery disease (CAD) is the leading cause of death in men and women, 1 and drug-eluting stents (DES) have become a mainstay of percutaneous coronary interventions. Increased attention is now being paid to outcome differences between different geographic regions and genders. Prior studies have shown that Latin Americans have high rates of cardiovascular disease and may have worse outcomes compared to patients in other regions.2-4 Latin American women may represent a particularly high-risk patient population, because female gender has also been implicated as a risk factor for worse outcomes after percutaneous coronary interventions (PCIs). 5,6 See page 239Prior studies have demonstrated the superior efficacy and safety of the XIENCE TM V everolimus-eluting stent (Abbott Vascular, Santa Clara, CA, USA) compared to first-generation DES 7,8 The XIENCE TM V SPIRIT Women study was the first dedicated prospective multicentre registry of women with de novo CAD.9 Approximately 10% of the study population in the SPIRIT Women registry was from Latin America, allowing for a unique opportunity to evaluate the outcomes of Latin American women compared to other women after receiving the XIENCE TM V stent.In this issue of the Revista Brasileira de Cardiologia Invasiva, Grinfeld et al. 10 report an analysis of the SPIRIT Women study, specifically comparing outcomes of women in Latin America to women from other regions. Overall, women from Latin America had higher rates of comorbid disease, including higher rates of hypertension, prior myocardial infarction and a family history of CAD. Furthermore, they had worse baseline angiographic characteristics, such as smaller reference vessel diameters and longer lesion lengths. These high rates of known CAD risk factors in Latin American patients have been previously reported © 2012 Elsevier Editora Ltda. and Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista. All rights reserved.and have been implicated in the overall high CAD rates observed in this population. 4,11,12 Hypertension, diabetes, and prior myocardial infarction rates appeared to be higher in this study when compared to prior studies in Latin American patients.11 This is not completely unexpected, since women in general have higher rates of these traditional risk factors than men. This study's all-female population has similar rates of comorbidities compared to other female populations included in clinical trials. 13Despite these differences in baseline characteristics, this study found that Latin American women had similar rates of the primary composite endpoint (all-cause death, myocardial infarction and target vessel revascularisation) compared to non-Latin American women (10.1% vs. 12.1%; P = 0.58). Furthermore, one-year mortality rates were low in both population subsets (0.7% in Latin American women vs. 1.6% in non-Latin American women). The rates of target vessel failure, death, and myocardial infarction in this study are comparable to re...