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ȣ - 550889 148 |
| Clinical Outcomes after Percutaneous Coronary Intervention According to the Hormonal Status in Women Patients with Coronary Artery Disease in Drug Eluting Stent Era |
| 가톨릭대학교 의과대학 내과학교실 |
| 김태석, 고윤석, 김태훈, 김찬준, 강민규, 황병희, 이정은, 진정연, 박만원, 신동일, 최윤석, 박훈준, 박찬석, 김동빈, 허성호, 이종민, 박철수, 김범준, 문건웅, 장기육, 김희열, 유기동, 정욱성, 승기배 |
Background: There was a paucity of data about the clinical outcomes according to the hormonal status in women undergoing percutaneous coronary intervention (PCI). So we compared the clinical outcomes between premenopausal and postmenopausal women and investigated whether the hormonal status has the prognostic power.
Methods: We analyzed consecutive 3358 female patients performed PCI with drug eluting stent (DES) in COACT (CathOlic medical center percutAneous Coronary inTervention) registry from January 2004 to December 2009. Primary object was a composite of major adverse cardiac events (MACE) including all-cause death, non-fatal myocardial infarction, and target vessel revascularization.
Results: Compared with postmenopausal women, premenopausal women were significantly younger (mean age, 68.7±8.4 vs. 46.2±4.9 years) and less likely to present hypertension, diabetes, hyperlipidemia. However, more likely to present with family history of CAD (4.4% vs. 11.3%, p=0.001). At 1 year, the MACE was similar for both groups (12.7% vs. 16.2%, p=0.227). In multivariable Cox regression analysis, the premenopausal state was associated with a significantly increased risk of MACE in women undergoing PCI, during 1-year follow-up period (adjusted hazard ratio, 1.885, 95% confidence interval 1.131-3.142) (table).
Conclusion: The premenopausal state is an independent risk factor of MACE in women undergoing PCI in DES era.
Keywords: Premenopause, Postmenopause, Coronary artery disease, Drug-Eluting Stents
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| Table. Predictors for major adverse cardiac events. |
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Adjusted HR |
95% CI |
p value |
| Premenopausal |
1.885 |
1.131 - 3.142 |
0.015 |
| Age |
1.012 |
0.999 - 1.024 |
0.067 |
| Current smoker |
1.351 |
1.047 - 1.745 |
0.021 |
| Hypertension |
1.308 |
1.036 - 1.652 |
0.024 |
| Diabetes mellitus |
1.099 |
0.897 - 1.347 |
0.363 |
| Family History of CAD |
0.862 |
0.513 - 1.449 |
0.576 |
| Number of diseased vessels |
1.228 |
0.993 - 1.615 |
0.142 |
| Number of lesions |
0.972 |
0.721 - 1.311 |
0.318 |
| B2/C lesion |
1.361 |
1.135 - 1.633 |
0.001 |
| Total stent number |
0.752 |
0.625 - 0.904 |
0.001 |
| Total stent length |
1.004 |
0.994 - 1.014 |
0.424 |
| Mean stent diameter |
0.674 |
0.504 - 0.901 |
0.008 |
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