Sex and age-specific 10-year mortality after coronary stenting: an analysis of two randomized trials.

Abstract

Aims: Over time, clinical outcome after percutaneous coronary intervention (PCI) with contemporary drug-eluting stents (DES) has improved. While most patients survive for many years after PCI, data on potential sex differences in age-specific 10-year mortality risk in all-comer patients are scarce. This study aimed to examine the sex- and age-specific 10-year mortality risk after PCI with new-generation DES.

Methods and results: This investigator-driven study assessed women and men, enrolled in our centre in two large-scale all-comer PCI trials (TWENTE and DUTCH PEERS; ClinicalTrials.gov NCT01066650 and NCT01331707, respectively), and compared their long-term mortality risk with that of the general population. The life status was checked in a national database of personal records. Information about the causes of death was obtained from medical records. Of all 2743 patients, 220/748 women and 461/1995 men died (29.4 vs. 23.1%, respectively, P < 0.001). Deceased patients had higher cardiovascular risk profiles and were older than patients who survived. Compared to the general population of a similar age, women and men who underwent PCI showed significantly increased 10-year all-cause mortality risks with a standardized mortality ratio of 2.13 [95% confidence interval (CI): 1.85-2.41] and 1.63 (95% CI: 1.48-1.78), respectively. No sex difference in causes of death was observed (cardiac, 28.2% women vs. 30.8% men, P = 0.46; vascular, 4.1 vs. 5.4%, P = 0.45; non-cardiovascular, 38.2 vs. 44.5%, P = 0.11).

Conclusion: PCI patients of both sexes showed higher 10-year age-specific mortality risks than the general population with a more pronounced difference observed in women. There was no sex difference in underlying causes of death. Furthermore, both women and men who died had higher cardiovascular risk profiles than those who survived.