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- Title
Gender-Related Differences in Antiplatelet Therapy and Impact on 1-Year Clinical Outcome in Patients Presenting With ACS: The START ANTIPLATELET Registry.
- Authors
Cirillo, Plinio; Di Serafino, Luigi; Patti, Giuseppe; Antonucci, Emilia; Calabrò, Paolo; Gresele, Paolo; Palareti, Gualtiero; Pengo, Vittorio; Pignatelli, Pasquale; Marcucci, Rossella
- Abstract
We investigated whether gender influences antiplatelet treatment in patients with acute coronary syndrome (ACS). The primary end point was major adverse cardiac and cerebrovascular events (MACCEs), a composite of death, myocardial infarction (MI), stroke, or target vessel revascularization. The coprimary end point was net adverse cardiac and cerebrovascular events (NACEs), based on MACCE plus major bleeding. From January 2014 to December 2016, 840 consecutive patients with ACS who completed 1-year follow-up were enrolled, 625 (74%) males and 215 (26%) females. Percutaneous coronary interventions (PCI) and drug-eluting stents (DES) were more often used in males (PCI: 532 [87%] vs 168 [80%], P = .02 and DES 474 [76%] vs 143 [66%], P = .01). Males were more often treated with dual antiplatelet therapy (DAPT; 94% vs 88%, P = .01). In DAPT, ticagrelor was the most prevalent strategy, regardless of gender (47% vs 49%, P = .68); clopidogrel was preferred in women (42% vs 33%, P = .04); and prasugrel was preferred in men (11% vs 17%, P = .04). At multivariate analysis, MACCE and NACE were similar between genders. Therefore, although P2Y12 inhibitor choice in DAPT might be influenced by gender, a DAPT choice, tailored by balancing the ischemic/bleeding risk, has a similar clinical outcome irrespective of gender.
- Subjects
ANTICOAGULANTS; CEREBROVASCULAR disease risk factors; ISCHEMIA; MYOCARDIAL infarction risk factors; HEMORRHAGE risk factors; CLOPIDOGREL; PLATELET aggregation inhibitors; MORTALITY risk factors; STROKE risk factors; CARDIOVASCULAR diseases risk factors; MULTIVARIATE analysis; SEX distribution; SURGICAL complications; DECISION making in clinical medicine; TREATMENT effectiveness; ACUTE coronary syndrome; DRUG-eluting stents; PERCUTANEOUS coronary intervention; DISEASE risk factors; THERAPEUTICS
- Publication
Angiology, 2019, Vol 70, Issue 3, p257
- ISSN
0003-3197
- Publication type
Article
- DOI
10.1177/0003319718783866