Abstract 16065: Sex-Specific Benefits of Sirolimus Eluting Stent on Long Term Outcomes in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Insights From the MULTISTRATEGY (Multicenter Evaluation of Single High-Dose Bolus Tirofiban Versus Abciximab With Sirolimus-Eluting Stent or Bare-Metal Stent in Acute Myocardial Infarction Study) Trial
Background. There is no data on sex-specific differences in long term benefit of sirolimus eluting stent (SES) use compared to bare metal stent (BMS) use among patients undergoing primary percutaneous coronary interventions (PCI).
Objectives. We assessed the relation between female sex and SES use on long term outcomes in acute myocardial infarction.
Methods. We performed a post-hoc analysis of the MULTISTRATEGY (Multicenter Evaluation of Single High-Dose Bolus Tirofiban Versus Abciximab With Sirolimus-Eluting Stent or Bare-Metal Stent in Acute Myocardial Infarction Study) trial. Hazard ratios (HR) of events with 95% confidence interval (CI) for sex and stent type were computed using cox proportional regression, with adjustment for confounders.
Results. A total of 744 patients, 64 (55-73) yrs-old, 179 (24.1%) women were enrolled. After a follow up of 1080 days, SES use was associated with a significant reduction of major adverse cardiovascular events (MACEs), i.e. the composite of all cause death, reinfarction, or clinically driven target vessel revascularization (TVR) (13.9% vs. 23.6%, adjusted HR 0.62, 95% CI 0.41 to 0.94, p=0.026) and of TVR (6.1% vs. 15.1%, adjusted HR 0.35, 95% CI 0.19 to 0.63, p<0.001) in men, but not among women (MACEs 21.9% in SES vs. 18.2% in BMS group, adjusted HR 1.27, 95% CI 0.53 to 3.02, p=0.59; TVR 6.6% vs.9.1%, adjusted HR 0.62, 95% CI 0.17 to 2.21, p=0.46; log rank test p=0.037 for MACEs, log rank test p=0.0014 for TVR across all groups).
Conclusions. In this analysis, the clinical benefit of SES use, over BMS, at 3 year follow up is restricted to men and is not present among women.
- © 2011 by American Heart Association, Inc.