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

DISRUPT BTK Study Shows Positive Results With Lithoplasty in Calcified Lesions Below the Knee
News | Peripheral Artery Disease (PAD)| September 20, 2017
Shockwave Medical reported positive results from the DISRUPT BTK Study, which were presented at the annual...
Heart Failure Market to Surpass $16 Billion by 2026
News | Heart Failure| September 19, 2017
The heart failure space across the seven key markets of the U.S., France, Germany, Italy, Spain, the U.K. and Japan is...
Corindus Announces First Patient Enrolled in PRECISION GRX Registry
News | Robotic Systems| September 18, 2017
September 18, 2017 — Corindus Vascular Robotics Inc.
Two-Year ILLUMENATE Trial Data Demonstrate Efficacy of Stellarex Drug-Coated Balloon
News | Drug-Eluting Balloons| September 18, 2017
Philips announced the two-year results from the ILLUMENATE European randomized clinical trial (EU RCT) demonstrating...
Sentinel Cerebral Protection System Significantly Reduces Stroke and Mortality in TAVR
News | Embolic Protection Devices| September 18, 2017
September 18, 2017 – Claret Medical announced publication of a new study in the...
Fysicon Receives FDA Approval for QMAPP Hemodynamic Monitoring System
Technology | Hemodynamic Monitoring Systems| September 18, 2017
Fysicon announced that it has been granted 510(k) clearance by the U.S. Food and Drug Administration (FDA) for its...
Marijuana Associated With Three-Fold Risk of Death From Hypertension
News | Hypertension| September 14, 2017
Marijuana use is associated with a three-fold risk of death from hypertension, according to research published recently...
Peter Schneider, M.D. presents late breaking clinical trial results at VIVA 17 in Las Vegas. Panelists (l to r) Krishna Rocha-Singh, M.D., Sean Lyden, M.D., John Kaufman, M.D., Donna Buckley, M.D.

Peter Schneider, M.D. presents late breaking clinical trial results at VIVA 17 in Las Vegas. Panelists (l to r) Krishna Rocha-Singh, M.D., Sean Lyden, M.D., John Kaufman, M.D., Donna Buckley, M.D.

Feature | Cath Lab| September 14, 2017
September 14, 2017 — Here are quick summaries for all the key late-breaking vascular and endovascular clinical trials
Mississippi Surgical and Vascular Center Uses Toshiba Ultimax-i FPD to Save Patients' Limbs
News | Angiography| September 14, 2017
The southern U.S. sees some of the highest numbers of chronic medical conditions, such as peripheral artery disease...
Sponsored Content | Videos | Structural Heart Occluders| September 13, 2017
Ziyad Hijazi, M.D., MPH, MSCAI, FACC, director of the cardiac program and chair of the Department of Pediatrics at Si
Overlay Init