(Press-News.org) Munich, Germany – Drug eluting stents (DES) are used less often in women treated with percutaneous coronary intervention (PCI) for coronary artery disease than men treated with PCI for the same condition, according to research presented today, August 25, at the ESC Congress 2012. The findings from a country-wide Germany registry were presented by Dr Martin Russ.
Coronary artery disease is still a leading cause of mortality and morbidity in Europe and worldwide. During treatment with PCI, cardiologists can use bare metal stents (BMS) or the newer DES. While they do not reduce mortality, DES are known to decrease the need for repeat target vessel revascularisation procedures compared to BMS, a major drawback of PCI compared to coronary artery bypass grafting (CABG).
The country-wide German registry, Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK) PCI registry, included 100,704 stent implantations between 2005 and 2009. The data revealed that women received a lower percentage of DES for every quarter of a year between 2005 and 2009.
The study also confirmed the smaller diameter of epicardial vessels in women.
"Cardiologists use a slightly but significantly lower percentage of DES than BMS when they treat women with PCI, compared to when they treat men," said Dr Russ. "This difference was found in all indications for which PCI was performed (stable angina and acute coronary syndrome). These results are even more remarkable given the smaller size of epicardial vessels in women, where DES are thought to provide an even more favourable long term result than BMS."
He added: "To our knowledge, except for our study, there are no data on the use of BMS and DES in a contemporary PCI register. A closer look at the data reveals that the difference in the rate of DES implantation between men and women increases with age."
The investigators found that in 70 to 80 year olds, men were 2.8% more likely to receive DES than women. In subjects over 80, men were 4.6% more likely to receive DES than women. Dr Russ said: "While there were no differences regarding DES use below the age of 70, the differences over 70 were significant. However, more than 40% of procedures were performed in patients over 70. One reason for these findings of the lesser use of DES in women could be the fear of a higher incidence of bleeding complications in women with the need for longer duration of dual antiplatelet therapy."
He added: "Neither guidelines on PCI nor any randomised trial support the preference of DES in men, as women receive the same advantages from DES. Furthermore, DES are the treatment of choice in most angiographic and clinical scenarios."
Dr Russ concluded: "Cardiologists should question themselves whenever they use BMS instead of DES, especially in women, to see whether their decision is justified. The lower use of DES in women compared to men may be putting them at a disadvantage and result in poorer outcomes."
###
Contributors:
M. Ruß1, C. Wackerl1, M. Hochadel2, J. Brachmann3, H. Mudra4, U. Zeymer5, M. A. Weber1
1Innere Medizin I, Kardiologie, Amper Kliniken AG, Klinikum Dachau;
2Institut für Herzinfarktforschung Ludwigshafen;
3II. Medizinische Klinik - Kardiologie, Angiologie, Pneumologie, Klinikum Coburg;
4Klinik für Kardiologie, Pneumologie und Intern. Intensivmed., Klinikum Neuperlach, Städtisches Klinikum München GmbH;
5Medizinische Klinik B - Abteilung für Kardiologie, Klinikum der Stadt Ludwigshafen GmbHs
Notes to editors
Please note that picture and CV from the author, abstract, picture and CV from spokesperson can be found here.
About the European Society of Cardiology www.escardio.org
The European Society of Cardiology (ESC) represents more than 75,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
About ESC Congress 2012
The ESC Congress is currently the world's premier conference on the science, management and prevention of cardiovascular disease. ESC Congress 2012 takes place 25-29 August at the Messe München in Munich. The scientific programme is available at: http://spo.escardio.org/Welcome.aspx?eevtid=54
More information is available from the ESC Press Office at press@escardio.org. END
Drug eluting stents used less often in women than men
2012-08-27
ELSE PRESS RELEASES FROM THIS DATE:
Passive smoking increases platelet activation in healthy people
2012-08-27
"It is well known that passive smoking is harmful for cardiovascular health, but the mechanism has not yet been discovered," said Dr Kaya. "We investigated the effects of passive smoking on the levels of three parameters – mean platelet volume (MPV), carboxyhemoglobin (COHb) and lactate - in an effort to further understand this mechanism. We also looked at the correlation between the three parameters."
Mean platelet volume (MPV) is a well established indicator of platelet activation that is increased in acute thrombotic events. It is suspected that carbon monoxide (CO) ...
Continuous spinal cord stimulation improves heart function
2012-08-27
Munich, Germany – Spinal cord stimulation improves heart function and could become a novel treatment option for heart failure, according to research presented at the ESC Congress 2012 today, August 25, by Professor Hung-Fat Tse from Hong Kong.
Heart failure is a progressive weakening of the heart muscle. It is a chronic condition that occurs when the heart cannot pump blood to meet the body's needs. When heart failure is present, not enough blood is circulating, which may cause fatigue. Further, fluid accumulation in the abdomen and legs and congestion in the lungs is ...
Copeptin predicts prognosis in HF patients
2012-08-27
Munich, Germany – Copeptin predicts prognosis in patients with heart failure, according to research presented at the ESC Congress today, August 25, by Professor Stefan Störk from Germany.
Increased levels of copeptin were associated with increased frequencies of typical co-morbidities of heart failure, increased severity of heart failure, and increased risk of all-cause death.
"Knowledge on the prognosis of patients with a chronic condition enables the physician to tailor the speed and intensity of treatment options to the individual patient," said Professor Störk. ...
Sudden death less likely in exercise related cardiac arrests
2012-08-27
Munich, Germany – People who have a cardiac arrest during or shortly after exercise are three times more likely to survive than those who have a cardiac arrest that is not exercise related, according to research presented at the ESC Congress 2012 today, August 26. The findings from the Amsterdam Resuscitation Study (ARREST) were presented by Dr Arend Mosterd from the Netherlands.
"Although physical activity is the best way to promote cardiovascular health, exercise can also trigger an acute cardiac event leading to death," said Dr Mosterd. "These dramatic and often high ...
Novel blood test predicts sudden death risk patients who would benefit from ICDs
2012-08-27
Munich, Germany – A novel blood test that predicts sudden death risk in heart failure patients is set to help physicians decide which patients would benefit from implantable cardioverter defibrillators (ICDs). The findings were presented at the ESC Congress 2012 today, August 26, by Professor Samuel Dudley from Chicago, IL, US.
Approximately 5 million patients in the US have heart failure, a condition where the heart is unable to pump blood adequately, and nearly 550,000 people are diagnosed annually. Heart failure is the single most common cause of admission to hospitals ...
ECG is a cost effective method for diagnosing cardiac abnormalities in young athletes
2012-08-27
Munich, Germany – Cardiovascular screening with ECG in young athletes is a cost effective way of diagnosing cardiac abnormalities, at just 138 Swiss Francs (about €115) per athlete. The findings were presented today, August 26, at the ESC Congress 2012 by Dr Andrea Menafoglio from Switzerland.
Sport is beneficial for health in most people. But for the small minority of the population who has cardiovascular abnormalities, sport can cause harm and very rarely – in one to three per 100,000 athletes per year – it can lead to sudden cardiac death.
"The cardiac arrest of ...
Electrical storm is a potent risk factor for mortality and morbidity
2012-08-27
Munich, Germany – Electrical storm (ES) is a potent risk factor for mortality and morbidity, according to research presented today, August 26, at the ESC Congress 2012 by Dr Federico Guerra from Italy. Data was also presented on which patients are prone to developing ES and how effective current treatments are.
Sustained ventricular arrhythmias, such as ventricular tachycardia (VT) or ventricular fibrillation (VF), are often seen as serious and devastating events, given their ability to lead to cardiac arrest and death if not treated promptly. Dr Guerra said: "The cluster ...
How ocean currents affect global climate is a question oceanographer may be close to answering
2012-08-27
TALLAHASSEE, Fla. - Kevin Speer has a "new paradigm" for describing how the world's oceans circulate — and with it he may help reshape science's understanding of the processes by which wind, water, sunlight and other factors interact and influence the planet's climate.
A Florida State University professor of oceanography with a passion for teaching, Speer and a colleague recently published a significant paper in the respected journal Nature Geoscience.
Working with John Marshall, an oceanography professor at the Massachusetts Institute of Technology, Speer reviewed ...
Compounds activate key cancer enzyme to interfere with tumor formation
2012-08-27
Scientists have known for decades that cancer cells use more glucose than healthy cells, feeding the growth of some types of tumors. Now, a team that includes researchers from the National Institutes of Health's new National Center for Advancing Translational Sciences (NCATS) has identified compounds that delay the formation of tumors in mice, by targeting a key enzyme that governs how cancer cells use glucose and its metabolites.
The study, published August 26 in the advance online publication of Nature Chemical Biology, was led by researchers from the Koch Institute ...
JCI early table of contents for Aug. 27, 2012
2012-08-27
New model of muscular dystrophy provides insight into disease development
Muscular dystrophy is a complicated set of genetic diseases in which genetic mutations affect the various proteins that contribute to a complex that is required for a structural bridge between muscle cells and the extracellular matrix (ECM) that provides the physical and chemical environment required for their development and function. The affects of these genetic mutations in patients vary widely, even when the same gene is affected. In order to develop treatments for this disease, it is important ...