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

Fragmin (dalteparin sodium) injection was cleared by the FDA for use in pediatric patients. It was initially approved by the FDA in 1994 for adults and is a type of heparin.

Fragmin (dalteparin sodium) injection is now cleared by the FDA for use in pediatric patients. It was initially approved by the FDA in 1994 for adults and is a type of heparin.

Technology | Antiplatelet and Anticoagulation Therapies | May 17, 2019
May 17, 2019 — The U.S.
PhaseBio Receives FDA Breakthrough Therapy Designation for Ticagrelor Reversal Agent
Technology | Antiplatelet and Anticoagulation Therapies | April 30, 2019
PhaseBio Pharmaceuticals Inc. announced the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy...
People With Heart Disease at Risk When Pharmacies Close
News | Antiplatelet and Anticoagulation Therapies | April 24, 2019
April 24, 2019 — New research from the University of Illinois at Chicago shows that when pharmacies close, people sto
Study Finds Only Six Percent of Patients Taking Statins as Directed
News | Antiplatelet and Anticoagulation Therapies | April 18, 2019
A recent study found patients with atherosclerotic cardiovascular disease cut their risk of a second major adverse...
HonorHealth Research Institute Launches SynIVUS-DAPT Study
News | Antiplatelet and Anticoagulation Therapies | April 16, 2019
HonorHealth Research Institute announced the first patients have been enrolled in the SynIVUS-DAPT Study. The clinical...
Lack of Physician Guidance, Fear of Side Effects Influence Statin Compliance
News | Antiplatelet and Anticoagulation Therapies | April 15, 2019
Despite national guidelines indicating statins can lower risk of heart attack and stroke, many patients who could...
Stopping DAPT After One Month Improved Outcomes in Stent Patients
News | Antiplatelet and Anticoagulation Therapies | March 25, 2019
Patients who stopped taking aspirin one month after receiving a stent in the heart’s arteries but continued taking the...
Apixaban Effective in Specific Cohort of Non-Valvular Atrial Fibrillation Patients
News | Antiplatelet and Anticoagulation Therapies | March 19, 2019
The Bristol-Myers Squibb-Pfizer Alliance announced results from the Phase 4 AUGUSTUS trial evaluating Eliquis (apixaban...
Researchers Develop Reversible, Drug-Free Antiplatelet Therapy
News | Antiplatelet and Anticoagulation Therapies | February 19, 2019
A new reversible, drug-free antiplatelet therapy could reduce the risk of blood clots and potentially prevent cancer...
FDA Approves Portola Pharmaceuticals' Prior Approval Supplement for Andexxa Generation 2 Manufacturing Process
News | Antiplatelet and Anticoagulation Therapies | January 02, 2019
The U.S. Food and Drug Administration (FDA) has approved Portola Pharmaceuticals’ Prior Approval Supplement (PAS) for...
Overlay Init