TAXUS Woman Analyzes Gender Influence on Long-Term Outcomes of PCI With the Paclitaxel-Eluting Stent

December 20, 2010—Ghada W. Mikhail, MD, et al published findings from the TAXUS Woman analysis in the Journal of the America College of Cardiology: Cardiovascular Interventions (2010;3:1250–1259). The investigators sought to assess the influence of sex on long-term outcomes after percutaneous coronary intervention using paclitaxel-eluting stents (PES) in a broad spectrum of patients.

According to the investigators, previous studies indicate that the sex gap suggesting worse outcomes in women has narrowed. However, limited data are available on long-term sex-based outcomes with drug-eluting stents despite their extensive use in current practice.

As detailed by the investigators, the study analyzed 2,271 PES-treated patients (665 women) from five randomized trials and 7,492 PES-treated patients (2,449 women) from two real-world registries. The trial and registry datasets were stratified by sex to compare long-term outcomes. Additionally, the outcomes in PES-treated women were compared with bare-metal stent–treated women (n = 395) in the randomized trials.

In the randomized trials, PES-treated women had a lower target lesion revascularization (TLR) rate (11.5% vs 22.6%; P < .001) than bare-metal stent–treated women, with no significant sex-based differences in death, myocardial infarction, stent thrombosis, or TLR through 5 years. In both the trials and the registries, although women had more adverse baseline characteristics, including advanced age, hypertension, and diabetes, they had similar outcomes to men. In expanded-use patients, however, women showed significantly higher rates of death and TLR, although only the higher TLR rate was confirmed by multivariate analysis.

The investigators concluded that despite their higher-risk profile, women have comparable benefits to men from percutaneous coronary intervention with PES except for a slightly higher revascularization rate in the high-risk cohort.