Sex differences in outcomes of carotid artery stenting
- PMID: 38797138
- DOI: 10.1016/j.jns.2024.123062
Sex differences in outcomes of carotid artery stenting
Abstract
Objective: Existing evidence is inconclusive on whether women after carotid artery stenting (CAS) experience worse outcomes than men.
Methods: The outcomes of women and men were compared using the data from nationwide retrospective registry between 2015 and 2019. The primary outcome was the incidence of ischemic stroke and all-cause death. Secondary outcomes included the incidence of ischemic stroke, all-cause death, acute occlusion, and acute myocardial infarction. Functional outcomes were the achieving an mRS score of 0-1 and 0-2. Outcomes were assessed at 30 days after CAS.
Results: In total, 9792 patients (1330 women, 8862 men; mean age, 73.8 vs 73.5 years, p = 0.17) were analyzed. Symptomatic stenosis was common in men (52.0% vs. 55.1%; p = 0.03), while ≥50% stenosis after CAS was common in women (3.2% vs. 2.0%; p = 0.005). The primary outcome was no significantly difference in women and men (2.0% vs. 1.9%; adjusted odds ratio [aOR], 1.19; 95% confidence interval [95%CI], 0.75-1.88).The incidence of all-cause death was higher in women (0.9% vs. 0.5%; aOR, 2.45; 95%CI, 1.11-5.39). Functional outcomes were significantly less common in women than in men (mRS0-1, 72.6% vs. 74.8%; aOR, 0.77; 95%CI, 0.63-0.95; mRS0-2, 82.1% vs. 85.6%; aOR, 0.76; 95%CI, 0.60-0.95).
Conclusions: This study suggests that there was no significant sex differences in the incidence of ischemic stroke and all-cause death at 30 days. However, women have higher rate of all-cause death and poorer functional outcomes at 30 days than men.
Keywords: Carotid artery stenting; Functional outcome; Sex.
Copyright © 2024 Elsevier B.V. All rights reserved.
Conflict of interest statement
Declaration of competing interest Dr. Uchida reports lecturer's fees from Daiichi Sankyo, Bristol-Myers Squibb, Stryker, and Medtronic. Dr. Shirakawa reports lecturer's fees from Stryker, Terumo, Johnson & Johnson, Kaneka, and Medtronic. Dr. Sakakibara reports a manuscript fee from Medicus Shuppan. Dr. Sakai N reports a research grant from Biomedical Solutions, Medtronic, Terumo and TG Medical; lecturer's fees from Asahi-Intec, Biomedical Solutions, Daiichi-Sankyo, Kaneka, Medtronic, and Terumo; membership on the advisory boards for Johnson&Johnson, Medtronic and Terumo outside the submitted work. Dr. Iihara reports a research grant from Idorsia Pharamaceutical Japan outside the submitted work. Dr. Imamura reports the lecturer's fees from Medtronic, Daiichi Sankyo, Stryker, Johnson & Johnson, Terumo, and Asahi Intecc. Dr. Ishii received a research grant from Fuji Film and lecture fees from Medtronic, Stryker, Terumo and Johnson and Johnson. Dr. Matsumaru discloses lecturer fees from Medtronic, Stryker, Terumo, Kaneka, Biomedical solution, E.P. Medical, B Braun, Daiichi Sankyo and Idorsia Pharmaceutical Japan outside the submitted work. Dr. Sakai C reports no conflict of interest. Dr. Satow reports research grants from CANON medical systems, lecturer's fees from Medtronic, and consulting fees from Kaneka Medix. Dr. Yoshimura reports research grants from Medico's Hirata, Medtronic, and Terumo; and lecturer fees from Medtronic, Kaneka, Stryker, Daiichi Sankyo, Bristol-Meyers Squibb, and Johnson & Johnson.
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