Sex Differences in Midterm Prognostic Implications of High Platelet Reactivity After Percutaneous Coronary Intervention With Drug-Eluting Stents in East Asian Patients: Results From the PTRG-DES (Platelet Function and Genotype-Related Long-Term Prognosis in Drug-Eluting Stent–Treated Patients With Coronary Artery Disease) Consortium

PTRG-DES Consortium Investigators

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Although high platelet reactivity (HPR) on clopidogrel is associated with higher ischemic events and lower bleeding events in patients who have undergone percutaneous coronary intervention with drug-eluting stents, the differential risk of HPR in East Asian women versus men is unknown. METHODS AND RESULTS: We compared 11 714 patients enrolled in the PTRG-DES (Platelet Function and Genotype-Related Long-Term Prognosis in Drug-Eluting Stent–Treated Patients With Coronary Artery Disease) Consortium according to sex and the pres-ence/absence of HPR on clopidogrel (defined as ≥252 P2Y12 reactivity units). The primary study end point was major adverse cardiac and cerebrovascular events (MACCEs; comprising all-cause mortality, myocardial infarction, cerebrovascular accident, and stent thrombosis). HPR was more common in women (46.7%) than in men (28.1%). In propensity-adjusted models, HPR was an independent predictor of MACCEs (men with HPR: hazard ratio [HR], 1.60 [95% CI, 1.20–2.12]; women with HPR: HR, 0.99 [95% CI, 0.69–1.42]) and all-cause mortality (men with HPR: HR, 1.61 [95% CI, 1.07–2.44]; women with HPR: HR, 0.92 [95% CI, 0.57–1.50]) in men, although those associations were insignificant among women. In addition, a significant interaction between sex was noted in the associations between HPR and MACCE (Pinteraction =0.013) or all-cause mortality (Pinteraction =0.025). CONCLUSIONS: In this study, HPR was a differential risk factor for 1-year MACCEs and all-cause mortality in women and men. And it was an independent predictor of 1-year MACCEs and all-cause mortality in men but not in women. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04734028. Registered July 9, 2003, https://clinicaltr ials.gov/ct2/show/NCT04734028.

Original languageEnglish
Article numbere027804
JournalJournal of the American Heart Association
Volume12
Issue number9
DOIs
Publication statusPublished - 2023 May 2
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 The Authors.

Keywords

  • coronary artery disease
  • drug-eluting stent
  • female
  • platelet function
  • sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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