Coronary interventions

Sex and long-term outcomes after implantation of the Absorb bioresorbable vascular scaffold for treatment of coronary artery disease

EuroIntervention 2019;15:615-622. DOI: 10.4244/EIJ-D-18-00603

Moritz Baquet
Moritz Baquet1, MD; Petra Hoppmann2, MD; David Grundmann1, MD; Wolfgang Schmidt1, MD; Sebastian Kufner3, MD; Hans D. Theiss1, MD; Stefan Brunner1, MD; Jens Wiebe3, MD; Madeleine Eickhoff1, MD; David Jochheim1, MD; Robert A. Byrne3,4, MD; Karl-Ludwig Laugwitz2,4, MD; Heribert Schunkert3,4, MD; Steffen Massberg1,4, MD; Adnan Kastrati3,4, MD; Julinda Mehilli1,4, MD
1. Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; 2. Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany; 3. Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; 4. Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Munich Heart Alliance, Munich, Germany

Aims: Women and men suffering from coronary artery disease differ in their risk profiles. We sought to investigate the impact of sex on two-year outcomes after BVS implantation in routine clinical practice.

Methods and results: Sex-based analysis of clinical outcomes was carried out by pooling the individual patient data of the ISAR-ABSORB and KUM-ABSORB registries performed in four high-volume tertiary centres in Munich. Of the total of 1,032 patients, 259 (25.1%) were women. The primary composite endpoint of death, target vessel myocardial infarction (TV-MI) and target lesion revascularisation (TLR) up to two years occurred in 13.2% of women and 17.9% of men (p=0.12). Compared to men, women experienced numerically lower rates of TLR and definite or probable BVS thrombosis – 7.5% vs 12.4% (p=0.051) and 1.2% and 2.7% (p=0.20), respectively. Independent predictors of increased risk for TLR were use of smaller size BVS (HR 1.28, 95% CI: 1.02-1.62), while being a woman was a protective factor (HR 0.59, 95% CI: 0.35-1.00).

Conclusions: BVS used in a routine setting tend to perform better among women compared to men, which might be partially related to the lower complexity of their coronary artery disease.

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