Sex Differences in Neointimal Hyperplasia Following Endeavor Zotarolimus-Eluting Stent Implantation.
- Alternative Author(s)
- Hur, Seung Ho
- Publication Year
- Inconsistent results in outcomes have been observed between the genders after drug-eluting
stent implantation. The aim of this study was to investigate gender differences in neointimal
proliferation for the Endeavor zotarolimus-eluting stent (ZES) and the Driver baremetal
stent (BMS). A total of 476 (n 391 ZES, n 85 BMS) patients whose volumetric
intravascular ultrasound analyses were available at 8-month follow-up were studied. At 8
months, neointimal obstruction and maximum cross-sectional narrowing (CSN) were significantly
lower in women than in men receiving ZES (neointimal obstruction 15.5 9.5%
vs 18.2 10.9%, p 0.025; maximum CSN 30.3 13.2% vs 34.8 15.0%, p 0.007).
Conversely, these parameters tended to be higher in women than in men receiving BMS
(neointimal obstruction 36.3 15.9% vs 27.5 17.2%, p 0.053; maximum CSN 54.3
18.6% vs 45.6 18.3%, p 0.080). There was a significant interaction between stent type
and gender regarding neointimal obstruction (p 0.001) and maximum CSN (p 0.003).
Multivariate linear regression analysis revealed that female gender was independently
associated with lower neointimal obstruction (p 0.027) and maximum CSN (p 0.004)
for ZES but not for BMS. Compared to BMS, ZES were independently associated with a
reduced risk for binary restenosis in both genders (odds ratio for women 0.003, p 0.001;
odds ratio for men 0.191, p <0.001), but the magnitude of this risk reduction with ZES was
significantly greater in women than men (p 0.015). In conclusion, female gender is
independently associated with decreased neointimal hyperplasia in patients treated with
ZES. The magnitude of risk reduction for binary restenosis with ZES is significantly greater
in women than in men. © 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108:
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