Women Reap the Benefits of Improvements in Coronary Stents

Joanne Foody, MD

In a meta-analysis of patient-level data, the superiority of newer-generation drug-eluting stents in women was consistent with results of clinical trials in both sexes.

Randomized trials have demonstrated the overall safety and efficacy of drug-eluting stents in the treatment of coronary artery disease; however, approximately three quarters of trial participants have been men. Because no individual trial has been sufficiently powered to assess the safety and efficacy of drug-eluting stents in women, these investigators pooled patient-level data on 11,557 women (mean age, 67) enrolled in 26 drug-eluting–stent trials and analyzed outcomes according to stent type (bare-metal stents [BMS], early-generation drug-eluting stents, and newer-generation drug-eluting stents).

The distribution of assigned participants and outcomes in the three stent groups are shown in the table. Compared with both BMS and early-generation drug-eluting stents, newer-generation drug-eluting stents were associated with significant reductions in the 3-year rates of the primary composite endpoint (a composite of death and myocardial infarction), stent thrombosis, and target-lesion revascularization. Results were consistent after adjustment for baseline differences among the groups.

CITATION(S):

Stefanini GG et al. Safety and efficacy of drug-eluting stents in women: A patient-level pooled analysis of randomised trials. Lancet 2013 Sep 2; [e-pub ahead of print].