A new analysis of the CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) trial examined gender differences in outcomes after treatment with angioplasty compared to stenting, with and without the antiplatelet agent abciximab, when women and men arrive at the hospital after a heart attack. The trial investigated the safety and efficacy of stents compared to angioplasty alone in heart attack patients.
In angioplasty, a small balloon-tipped catheter is inserted into a blocked artery, and then the balloon is inflated to open the artery. Stenting is performed in conjunction with angioplasty, wherein a mesh tube called a stent is positioned to help keep the unblocked artery open.
"Angioplasty is known to save lives in the setting of a heart attack and saves more lives of women than men," said lead author Alexandra J. Lansky, M.D. "For every 1,000 patients treated with percutaneous coronary interventions, an estimated 56 deaths are prevented for women compared to 42 deaths prevented for men. There is a larger absolute benefit for women because of their higher risk profile."
Lansky is director of clinical services for interventional cardiology at New York-Presbyterian Hospital/Columbia and associate professor of clinical medicine at Columbia University Medical Center in New York City and director of the Women's Health Initiative at the Cardiovascular Research Foundation.
Based on the CADILLAC findings, Lansky suggested that stenting may be the preferred treatment choice for women with heart attack.
"Stenting is the best alternative among excellent treatment options for women," she said. "There is no difference in the death rates between stenting and angioplasty, but
Contact: Carole Bullock
American Heart Association