Despite the fact that symptomatic coronary disease afflicts men and women equally, only 33 percent of the 1.2 million interventional procedures conducted in the U.S. each year are done on women. The difference is at least partially the result of a belief by doctors that women do not respond as well to the treatments, but the Columbia University Medical Center study, published in today's Journal of the American College of Cardiology, shows that drug eluting stents are just as effective and safe in women as they are in men.
"The prevailing opinion has been that percutaneous coronary interventions including drug eluting stents are more dangerous in women and don't provide the same benefit, but our study shows that there is no scientific basis for this," said the study's principal investigator Alexandra Lansky, MD, associate professor and director of clinical services for interventional cardiology at Columbia University Medical Center and director of the Women's Health Initiative at the Cardiovascular Research Foundation. "There is no reason that women should be receiving this treatment less than men."
In patients with narrowing of arteries due to clogging, drug eluting stents can be safely used to treat the narrowing, with durable results and very low rates of recurrence and in some cases prevent subsequent heart attacks.
The study found that there is no difference in levels of restenosis with the use of drug eluting stents - the angiographic measurement of how narrow the vessel becomes after treatment - between women and men. And yet, contrary to previous reports, the study also showed that doctors re-intervene in female patients twice as often as in men.
Dr. Lansky says the higher re-intervention rate in women may be related to the fact that women have smaller vessels, and the narrowing may look worse in them than in men, resulting in more interventions. Re-interventions include re-expanding stents using balloon angioplasty or adding additional stents.
The study showed that men and women had comparable low rates of cardiac death after treatment with the drug eluting stents - 0.5 percent in women, 1.7 percent in men. Similarly, the heart attack rates were also comparably low - 2.7 percent in women, 3.8 percent in men.
Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, medical education, and health care. The medical center trains future leaders in health care and includes the dedicated work of many physicians, scientists, nurses, dentists, and other health professionals at the College of Physicians & Surgeons, the School of Dental & Oral Surgery, the School of Nursing, the Mailman School of Public Health, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. With a strong history of some of the most important advances and discoveries in health care, its researchers are leading the development of novel therapies and advances to address a wide range of health conditions. www.CUMC.Columbia.edu.
The Cardiovascular Research Foundation in New York City is one of the world's largest private, not-for-profit medical research foundations dedicated to promoting advances in interventional vascular medicine. Its mission is involvement in every stage of translating ideas into practice in interventional cardiology, from research and education to treatment. Founded in 1991, the Cardiovascular Research Foundation has maintained an international reputation for leadership and innovation in the development of minimally invasive techniques and drug-based treatments of heart and vascular diseases.