New-generation DES may reduce risk for TLR, stent thrombosis in older women

ANAHEIM, Calif. — Older women who underwent PCI with new-generation drug-eluting stents had reduced risk for target lesion revascularization and stent thrombosis vs. those who received early-generation DES, according to data presented at American Heart Association Scientific Sessions.

These benefits did not lead to a consistent reduction in MI and death, according to the abstract.

Birgit Vogel, MD, postdoctoral research fellow at Icahn School of Medicine at Mount Sinai, and colleagues analyzed data from 4,631 women aged at least 70 years who underwent PCI from 26 randomized controlled trials.

Device-oriented endpoints of interest included TLR and stent thrombosis. Patient-oriented endpoints of interest were death and MI. Women were followed up for 3 years.

New-generation DES were used in 58.76% of women. Compared with early-generation DES, patients who received a new-generation DES had lower rates of TLR (5.1% vs. 6.7; P = .023) and stent thrombosis (0.6% vs. 1.2%; P = .055). The rate of death (9.2% vs. 9.3%; P = .934) and MI (5.7% vs. 6.4%; P = .527) were similar in both groups.

The findings were largely unchanged after adjusting for multiple variables, with strong trends toward a reduced risk for stent thrombosis (adjusted HR = 0.5; 95% CI, 0.24-1.06; P = .071) and TLR (aHR = 0.79; 95% CI, 0.59-1.05; P = .098) in patients with a new-generation DES vs. early-generation DES.

“As the elderly female population undergoing PCI continues to increase, further studies dedicated to improving their outcomes are warranted,” Vogel and colleagues wrote in an abstract. – by Darlene Dobkowski

Reference:

Vogel B, et al. Drug-Eluting Stents: Contemporary Issues. Presented at: American Heart Association Scientific Sessions; Nov. 11-15, 2017; Anaheim, Calif.

Disclosure: Vogel reports no relevant financial disclosures.