Overall, both men and women experience post-surgical complications such as fever and or chills, chest pain, and nausea after angioplasty but the worse outcomes can cause bleeding, cardiac arrest, congestive heart failure, stroke, and kidney failure.
Women, however, are at a higher risk of bleeding following percutaneous coronary intervention (PCI ) or angioplasty with stents, says a recent secondary analysis of the LEADERS FREE randomized clinical trial published in Journal of the American Medical Association (JAMA).
Sex-Based Outcomes in Patients With a High Bleeding Risk After Percutaneous Coronary Intervention and 1-Month Dual Antiplatelet Therapy: A Secondary Analysis of the LEADERS FREE Randomized Clinical Trial | Acute Coronary Syndromes | JAMA Cardiology https://t.co/JpHNB9OlHQ
— くりにかる薬剤師＠臨床薬理＠Ph.D. (@clinical89314) May 21, 2020
The analysis focused on patients with underlying heart problems like bleeding after angioplasty. Cardiovascular disease (CVD) is the leading cause of death in the world. It claims around 18 million lives a year worldwide and 85% of all CVD deaths are due to heart attacks and strokes, according to the world health organization (WHO). Another report by the American College of Cardiology (ACC) found that 6.2 million Americans suffered heart failure during 2013-2016
To analyze bleeding after PCI, a team of researchers studies a sample collected from 68 sites in 20 different countries from December 2012 to May 2014 and analyzed the data for up to two years. There were 2432 participants included in the study who underwent PCI. Of the total, 69.7% and 30.3% of the participants were male and female, respectively, with a mean age of 75 years.
Primary Safety End Point: The main results measured at the end of the study had three outcomes including cardiac death, myocardial infarction or heart attack, and stent thrombosis which is a major complication linked with stent placement during PCI.
The team found the primary safety endpoint in 14.7% and 13.6% of the women and men, respectively.
Primary Efficacy End Point: During the laboratory trials, the clinical outcome after the randomization was Target lesion revascularization (TLR), a revascularization method performed to the restoration of the organ that had gone through ischemia. The method applied to those patients who come back with clinical symptoms such as unstable angina or chest pain that increases in frequency, intensity, or duration.
For the current study, the researchers found the primary efficacy endpoint in 9.2% and 9.5% of the females and males, respectively.
Drug-Coated Stent VS Bare-Metal Stent
The team also determined that those patients who received a drug-coated stent were less likely to undergo TLD including 6.3% females and 12.1% males as compared to those patients who received bare-metal stent that included 7% of the women and 12% of the men.
For the assessment of the bleeding, the investigators used bleeding academic research consortium (BARC) scale that aimed at evaluating coronary stents by following a graded system. It has 2, 3, or 4 grades according to the severity level that has a link with gradually increasing the risk of death.
The team found a bit higher bleeding episode in the first 30 days after PCI in women (10.2%) than men (8.6%).
By taking all into account, the researchers suggested that no significant differences was found in both genders in experiencing the bleeding episode. But it has been determined that women are more prone to experience early bleeding after PCI than men.
How to Reduce the Chances of Getting Acute Coronary Syndrome
Acute coronary syndrome (ACS) is a rather unfamiliar term but the majority is aware of a heart attack or unstable angina. Both of these conditions lie under ACS. Medical health professionals often prescribe antithrombotic medications and early revascularization to patients with ACS that result in bleeding problems.
According to a report by The National Center for Biotechnology Information (NCBI), major bleeding caused by ACS is responsible for a 60% increased risk of in-hospital death.
Some steps can be used to reduce the chances of developing ACS such as quitting smoking and cocaine use, controlling hypertension, diabetes, and obesity.
— The BMJ (@bmj_latest) October 21, 2015