Candace Stuart, editor, Cardiovascular Business

Have we broken the plaque ceiling? A study in the March issue of the Journal of the American College of Cardiology: Cardiovascular Interventions found that women who underwent PCI with a drug-eluting stent had a similar risk of cardiac death and MI as men at two-year follow-up and had equivalent safety and efficacy at two years.

It is well established that women may not show the classic MI symptoms of chest pain, for instance. While heart disease is the No. 1 killer of women, it was long thought to be a man’s disease, and women remained uninformed and unaware about their risks.

That has changed, and today there is a similar effort to raise awareness that peripheral artery disease, like coronary disease, is prevalent in women. Many women and some physicians remain in the dark on this issue, though.   

As the study notes, a million PCIs are performed annually in the U.S., with a third in women. The women patients were more likely to be older, have more cardiovascular risk factors, with the exception of smoking, and a lower degree of angiographic complexity based on the SYNTAX score.

“The similar outcomes in terms of cardiac death, MI and stent thrombosis are reassuring and reinforce the lack of a sex gap in terms of patient and device safety,” the authors concluded.

I lean toward the view of accompanying editorial writers, who point to biological differences in vascular form, function—and yes, atherosclerotic plaque—between the sexes. They argue we need more sex-specific investigations.

This study shows we have come a long way, but we still have a ways to go.

Candace Stuart
Editor, Cardiovascular Business
CStuart@cardiovascularbusiness.com