March 25, 2020
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In PCI with dual-therapy stent, no sex differences at 1 year

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Jaya Chandrasekhar

At 1 year, women experienced similar target lesion failure and ischemic outcomes compared with men after PCI with a dual-therapy stent, according to research published in Catheterization and Cardiovascular Interventions.

Among patients who underwent PCI with the dual-therapy stent (Combo, OrbusNeich Medical Technologies), the 1-year findings showed similar outcomes for TLF between men and women (women, 3.8%; men, 3.9%; HR = 0.92; 95% CI, 0.59-1.42), with no sex differences for incidence of cardiac death (women, 1.6%; men, 1.5%; P = .78), target vessel MI (women, 1.5%; men, 1.1%; P = .32) or clinically driven target lesion revascularization (women, 2%; men, 2.2%; P = .67).

According to the study, definite or probable stent thrombosis occurred in 0.4% of women and 1% of men (HR = 0.26; 95% CI, 0.06-1.11).

Researchers determined that despite the women being older (67 vs. 62 years; P = .001) at baseline and having higher prevalence of comorbidities including diabetes (33.1% vs. 28.1%; P = .004), hypertension (77.1% vs. 64.4%; P < .001) and HF (8.3% vs. 5.7%; P = .005), the findings remained consistent with little to no sex differences at 1-year follow-up.

The dual-therapy stent uses luminal endothelial progenitor cell capture technology to promote endothelialization, according to the study background. It is not approved for commercial use in the United States.

“The current study furthers research on sex differences after PCI with new-generation DES,” Jaya Chandrasekhar, MBBS, MS, postdoctoral research fellow at the Icahn School of Medicine at Mount Sinai Hospital and interventional cardiologist at Amsterdam University Medical Center, and colleagues wrote. “While our results are reassuring for the low event rates in women after Combo PCI, these results also suggest that more efforts are needed with contemporary PCI in women to improve guideline-directed practice for use of radial access and potent antiplatelet therapy.”

Researchers assessed the 1-year outcomes after dual-therapy stenting among patients from the COMBO collaboration, a pooled patient-level data set from the MASCOT and REMEDEE multicenter registries, that included 3,614 patients (24% women) who underwent PCI.

“Although data on feasibility of early dual antiplatelet therapy cessation after Combo PCI are available from the REDUCE trial, and notwithstanding the trend for lower stent thrombosis events in women noted in the current study, we cannot comment on safety of routine early DAPT cessation in women receiving Combo stents from this study,” the researchers wrote. – by Scott Buzby

Disclosures: One author reports she has financial ties with numerous pharmaceutical, device and publishing companies, including OrbusNeich. The other authors report no relevant financial disclosures.