ESC.13: Newer drug-eluting stents outshine others in women

Drug-eluting stents (DES) are safer and more effective than bare-metal stents in women with coronary artery disease, according to the results of an international study presented at the European Society of Cardiology Congress 2013 in Amsterdam and simultaneously published online Sept. 2 in The Lancet. Women who received newer DES experienced fewer deaths or heart attacks than women with older DES or bare-metal stents.

While one-third of more than 500,000 patients who receive DES in the U.S. annually are women, they make up only about 25 percent of participants in DES safety and efficacy studies. In response, the Society of Cardiovascular Angiography and Interventions Women in Innovation Initiative (SCAI-WIN) undertook an analysis of 26 DES trials and pooled the patient-level data for females (11,557 of 43,904 total participants).

As the primary outcome, the researchers, led by Giulio G. Stefanini, MD, of Bern University Hospital in Switzerland, utilized the combination of death or heart attack.

After a three-year follow-up period, the primary outcome occurred in 12.9 percent of women who received bare-metal stents, 10.9 percent of women who had older DES and 9.2 percent of women who had newer DES.

Additionally, newer DES were associated with a reduced need for revascularization (6.3 percent vs. 7.8 percent for older DES and 18.6 percent for bare-metal stents).

“This study is the first comprehensive large-scale analysis of safety and efficacy of drug-eluting stents in women, bridging a critical information gap in cardiovascular research,” said SCAI-WIN co-founder Roxana Mehran, MD, in a press release. “The global response and collaboration on this effort is unprecedented and represents a large step forward for women in cardiovascular disease treatment. These findings will help cardiologists deliver optimal care for patients.”

Based on the results of the meta-analysis, newer-generation DES “should be thought of as the standard of care for percutaneous coronary revascularization in women,” the authors concluded.