News | Antiplatelet and Anticoagulation Therapies | May 16, 2016

Study Finds Young Women at Greater Risk for Adverse Outcomes Following PCI

Women at higher risk for PCI for acute coronary syndrome due to greater baseline comorbidities

PROMETHEUS, anticoagulation in women

May 16, 2016 – Women younger than 55 years of age who undergo percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) are more likely to experience one-year adverse cardiovascular events due to risk factors such as diabetes and chronic kidney disease, yet they are less likely to receive potent antiplatelet therapy than men. The PROMETHEUS study found that outcomes for both men and women post-PCI are dependent on their baseline risk factors, not their sex. The results were presented as a late-breaking clinical trial at the 2016 Society for Cardiovascular Angiography and Interventions (SCAI) annual meeting.

PROMETHEUS was a retrospective, multicenter observational study comparing outcomes in patients treated with clopidogrel versus those who were treated with the more potent therapy, prasugrel, following ACS PCI. The study looked at outcomes up to one year and tracked major adverse cardiac events (MACE) and bleeding risks. MACE was defined as a composite of death, myocardial infarction, stroke or unplanned revascularization at one year. Clinically significant bleeding was defined as bleeding that required a transfusion or hospitalization.

“Taking into account all risk factors, we wanted to find out if there was a difference in treatment between men and women,” said study co-principal investigator Usman Baber, M.D. MS, and post-doctoral research fellow Jaya Chandrasekhar, MBBS, MRCP, FRACP from the Icahn School of Medicine at Mount Sinai, N.Y.

The study cohort included a total of 4,851 patients. Of those, 1,162 (24 percent) were women and 3,689 (76 percent) were men. The prevalence of diabetes (41 vs. 27.9 percent) and chronic kidney disease (12.7 vs. 7.2 percent) was higher among women than men.

Irrespective of sex, prasugrel was used in less than one-third of patients (31.8 percent in men vs. 28.1 percent in women, p= 0.01). Unadjusted, MACE at one year was significantly higher in women than in men (21.1 vs. 16.2 percent). After multivariable adjustment (HR 1.13, 95 percent CI 0.93-1.36), results were no longer significant. Women also had more bleeding than men (3.6 vs. 2.2 percent, p=0.01), without differences in adjusted risk (HR 1.23, 95 percent CI 0.78-1.95).

“What this study demonstrated is that it is important to objectively assess all the risk factors when considering which therapy to administer,” said the authors. “In the real world physicians are more likely to consider thrombotic risk in men but bleeding risk in women for prescription of prasugrel or clopidogrel.”

Baber and Chandrasekhar reported no disclosures.

For more information: www. SCAI.org/SCAI2016 

Related Content

Xarelto Reduces Ischemic Stroke for Coronary and Peripheral Artery Disease Patients
News | Antiplatelet and Anticoagulation Therapies | February 19, 2018
A late-breaking analysis of the landmark COMPASS study was presented at the 2018 International Stroke Conference (ISC...
Abbott Begins Enrollment in XIENCE 28 GLOBAL DAPT Trial
News | Antiplatelet and Anticoagulation Therapies | February 13, 2018
Abbott announced the first patient has been enrolled in a clinical trial evaluating 28 days of dual antiplatelet...
Baxter Announces FDA Approval of Ready-to-Use Cardiovascular Medication Bivalirudin
Technology | Antiplatelet and Anticoagulation Therapies | January 22, 2018
January 22, 2018 — Baxter International Inc. announced the U.S.
News | Antiplatelet and Anticoagulation Therapies | January 19, 2018
The U.S. Food and Drug Administration (FDA) announced that International Laboratories LLC is voluntarily recalling Lot...
New Oral Anticoagulant Drugs Associated with Lower Kidney Risks
News | Antiplatelet and Anticoagulation Therapies | December 12, 2017
Mayo Clinic researchers have shown a link between which type of oral anticoagulant a patient takes to prevent a stroke...
News | Antiplatelet and Anticoagulation Therapies | November 16, 2017
Bristol-Myers Squibb Company and Pfizer Inc. released real-world data (RWD) of outcomes associated with direct oral...
Six Months of DAPT Non-Inferior to Twelve in STEMI Patients Receiving Drug-Eluting Stents
News | Antiplatelet and Anticoagulation Therapies | November 06, 2017
November 6, 2017 —  The first trial to evaluate the safety of...
Statins Attributed With 10-Year Cholesterol Drop for Malaysian Heart Attack Patients
News | Antiplatelet and Anticoagulation Therapies | November 03, 2017
November 3, 2017 — A ten-year decline in the blood cholesterol of heart attack patients in Malaysia suggests...
COMPASS Trial Shows Rivaroxaban With Aspirin Improves Stable Cardiovascular Disease
Feature | Antiplatelet and Anticoagulation Therapies | September 12, 2017
September 12, 2017 — Rivaroxaban plus aspirin improves survival and reduces stroke and heart attack in patients with
Real-World Analysis Compares Safety, Effectiveness of Apixaban Versus Warfarin
News | Antiplatelet and Anticoagulation Therapies | August 28, 2017
August 28, 2017 — Bristol-Myers Squibb Company and Pfizer Inc.
Overlay Init