Stents May Improve Long-Term Outcomes in Women With AMI

New-generation drug-eluting stents (DES) are associated with a lower risk of mortality and myocardial infarction (AMI), as well as other consistent and durable benefits, in women with AMI, according to a recent study.

Women with AMI receiving mechanical reperfusion have a higher risk of adverse cardiac events and mortality compared with men undergoing the procedure. Whether the benefits of new-generation DES are preserved long term in women remains unclear.
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In the Women in Innovation and Drug-Eluting Stents (WIN-DES) collaborative study, the researchers analyzed 11,557 women enrolled in 26 different clinical trials from July 2016 to December 2016. Patients’ mean age was 66.8 years.

To be included in the study, patients had to have an acute coronary syndrome, such as those presenting with unstable angina (UA) vs AMI. AMI included non-ST-segment elevation MI (NSTEMI) or ST-segment elevation MI (STEMI). Each was randomly assigned to early DES (sirolimus- or paclitaxel-eluting stents) or new-generation DES (everolimus-, zotarolimus-, or biolimus-eluting stents).

A total of 4373 participants (37.8%) had an acute coronary syndrome. Of these, 2176 (49.8%) had an AMI. In women with AMI, new-generation DES were related to decreased risk of mortality, MI, or target lesion revascularization and definite or probable stent thrombosis without evidence of interaction for both end points, vs women without AMI.

The researchers saw a graded absolute benefit with use of new-generation DES in the transition from UA, to NSTEMI, and to STEMI.

“New-generation DES are associated with consistent and durable benefits over 3 years in women presenting with acute MI,” the researchers concluded. “The magnitude of these benefits appeared to be greater per increase in severity of acute coronary syndrome.”

—Christina Vogt

Reference:

Giustino G, Harari R, Baber U, et al. Long-term safety and efficacy of new-generation drug-eluting stents in women with acute myocardial infarction: from the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration [Published online June 28, 2017]. doi:10.1001/jamacardio.2017.1978.