Gender peculiarities of endovascular coronary revascularization by stenting of coronary arteries in patients who suffered myocardial infarction: 5-year follow-up results

The article presents data on clinical and functional evaluation of gender-dependent peculiarities in CAD patients with coronary artery stenting based on results of 5-year follow-up study. Group 1 consisted of 46 men (mean age: 51.79±8.70 years); group 2 consisted of 26 postmenopause women (mean age: 57.85±8.58 years, p=0.007). Changes in exercise tolerance, lipid spectrum indices, left ventricular (LV) remodeling, and rates of coronary stent restenosis were assessed at baseline and at 1, 3, and 5 years after the intervention. Data showed that clinical courses of CAD (frequency of recurrent angina and unstable angina) did not differ between men and women, but women demonstrated higher glycemia and fibrinogen levels at the all follow-up points resulting in the increased rates of bare-metal stent restenosis/occlusion 3 to 5 years after the intervention compared with men. No differences in the rates of required repeated myocardial revascularizations were found between men and women, but the underlying causes for the repeated procedures differed: progression of coronary atherosclerosis prevailed in men (25 and 27.9% for 3- and 5-year follow up, respectively) whereas bare-metal stent restenosis/ occlusion was more frequent cause in women (24% and 20% for 3- and 5-year follow up, respectively). Five-year survival rates did not significantly differ in men and women but unfavorable cardiovascular events including cardiogenic death, MI after coronary artery stenting, and repeated myocardial revascularizations occurred less frequent (by 20.1%) in women (p=0.047).