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Gender Differences in Clinical Outcomes After Percutaneous Coronary Interventions With Zotarolimus-Eluting Stents: Insights From the Korean Endeavor Registry

Background:The impact of gender on outcomes after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents is not known in Asian patients. The authors studied outcomes after PCI with zotarolimus-eluting stent in unselected consecutive series of Asian patients according to gender. Methods:Outcomes among patients treated with zotarolimus-eluting stents from multicenter registry were evaluated by gender. The primary outcome was major adverse cardiac events, composite of cardiac death, myocardial infarction and target lesion revascularization at 1 year. Results:Of 2,840 patients, 855 (30.1%) were women. Comparatively, women were older; more frequently had diabetes, hypertension, and dyslipidemia; less frequently women were current smokers, had previous myocardial infarctions and previous PCIs; were more likely to have culprit lesions in left anterior descending coronary artery; and underwent more multilesion PCIs. After adjustment for baseline differences, women were still at lower risk of major adverse cardiac events (38 [4.4%] versus 137 [6.9%], adjusted hazard ratio [HR]: 0.52, 95% confidence interval [CI]: 0.30–0.89, P = 0.018), mainly driven by target lesion revascularization (24 [2.8%] versus 106 [5.3%], adjusted HR: 0.41, 95% CI: 0.24–0.70, P = 0.001) at 1 year, although rates of cardiac death, myocardial infarction and stent thrombosis were similar between genders. These results were consistent after propensity score-matched population analysis (for major adverse cardiac events, adjusted HR: 0.36, 95% CI: 0.18–0.69, P = 0.012; for target lesion revascularization, adjusted HR: 0.32, 95% CI: 0.15–0.69, P = 0.004) and were also constant among various high-risk subgroups. Conclusions:Despite greater baseline clinical and angiographic risk, the use of the zotarolimus-eluting stent is associated with favorable outcomes among Asian women treated with PCI.