NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Dolor RJ, Melloni C, Chatterjee R, et al. Treatment Strategies for Women With Coronary Artery Disease [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Aug. (Comparative Effectiveness Reviews, No. 66.)

Cover of Treatment Strategies for Women With Coronary Artery Disease

Treatment Strategies for Women With Coronary Artery Disease [Internet].

Show details

Appendix GSummary Table for Modifiers of Effectiveness

Table G-1Summary of RCTs reporting modifiers of effectiveness (subgroup analyses)

Study
Author/Year
Related Articles
PopulationComparison# SubjectsSubgroup AnalysesQuality
BARI
Jacobs et al., 19981

and

Gibbons et al., 20072
Anonymous, 20073
Lombardero et al., 20024
Anonymous, 20005
Hlatky et al., 19956
Rogers et al., 19957
Sutton-Tyrrell et al., 19988
Mullany et al., 19999
Anonymous, 199610
Stable/unstable angina

Diabetics
PCI vs. CABGTotal: 915
Women: 249 (27%)
7-year survival rates
Women: PCI 61.0% vs. CABG 74.3%
Men: PCI 51.5% vs. CABG 77.9%
Good
Minai et al., 200211STEMI age ≥ 80 yearsPCI vs conservative/supportive therapyTotal: 120
Women: 60 (50%)
No difference in composite outcome (death/congestive heart failure/repeat MI/cerebrovascular accident at 3 years between treatment groups).Fair
PAMI
Stone et al., 199512
STEMIPCI vs. fibrinolysis (t-PA)Total: 395
Women: 107 (27%)
In-hospital mortality
Women aged <65: 0% vs. 4%; p = 0.42
Women aged ≥65: 5.9% vs. 21.9%; p = 0.58

Men aged <65: 0.9% vs. 0%; p = 0.74
Men aged ≥65: 5.6% vs. 10.4%; p = 0.42
Good
RITA-3
Clayton et al., 200413

and

Fox et al., 200214
UA/NSTEMIEarly invasive (PCI) vs. initial conservativeTotal: 1,810
Women: 682 (38%)
Lower TIMI risk scores, both men and women had similar event rates in early invasive vs. initial conservative treatment arms.

In those with moderate to high risk, men had lower event rates in intervention arm compared with conservative arm while women had higher even rates in the intervention arm.

Moderate risk (women)
Invasive: 13.4%
Conservative: 3.4%

High risk (women)
Invasive: 11.7%
Conservative: 8.2%

Moderate risk (men)
Invasive: 5.4%
Conservative: 9.4%

High risk (men)
Invasive: 10.3%
Conservative: 17.9%

No benefit of intervention was seen in any BMI group for women.
Good
TACTICS TIMI-18
Cannon et al., 200115

and

Glaser et al., 200216
Cannon et al., 199817
UA/NSTEMIEarly invasive (PCI) vs. initial conservativeTotal: 2,220
Women: 757 (34%)
Primary endpoint
(death/MI/rehospitalization for acute coronary syndrome by risk)

Women with intermediate (3–4) and high (5–7) TIMI risk scores did not have significantly different outcomes in early invasive vs. initial conservative group.

OR (95% CI) 0.72 (0.45 to 1.16) vs. 0.56 (0.23 to 1.32)
Good

Abbreviations: BMS = bare metal stent; CABG = coronary artery bypass graft; CAD = coronary artery disease; CI = confidence interval; DES = drug-eluting stent; HCT = hematocrit; MI = myocardial infarction; NSTEMI = non-ST elevation myocardial infarction; OR = odds ratio; PCI = percutaneous coronary intervention; PTCA = percutaneous transluminal coronary angioplasty; RCT = randomized controlled trial; TIMI = thrombolysis in myocardial infarction; t-PA = tissue plasminogen activator; UA = unstable angina

References Cited in Appendix G

1.
Jacobs AK, Kelsey SF, Brooks MM, et al. Better outcome for women compared with men undergoing coronary revascularization: a report from the bypass angioplasty revascularization investigation (BARI) Circulation. 1998;98(13):1279–85. [PubMed: 9751675]
2.
Gibbons RJ, Miller DD, Liu P, et al. Similarity of ventricular function in patients alive 5 years after randomization to surgery or angioplasty in the BARI trial. Circulation. 2001;103(8):1076–82. [PubMed: 11222469]
3.
The final 10-year follow-up results from the BARI randomized trial. J Am Coll Cardiol. 2007;49(15):1600–6. [PubMed: 17433949]
4.
Lombardero MS. Seven-year outcome in the bypass angioplasty revascularization investigation (BARI), by treatment and presence of diabetes. Cardiovasc Rev Rep. 2002;23(1):14–18.
5.
Seven-year outcome in the Bypass Angioplasty Revascularization Investigation (BARI) by treatment and diabetic status. J Am Coll Cardiol. 2000;35(5):1122–9. [PubMed: 10758950]
6.
Hlatky MA, Charles ED, Nobrega F, et al. Initial functional and economic status of patients with multivessel coronary artery disease randomized in the Bypass Angioplasty Revascularization Investigation (BARI) Am J Cardiol. 1995;75(9):34C–41C. [PubMed: 7892821]
7.
Rogers WJ, Alderman EL, Chaitman BR, et al. Bypass Angioplasty Revascularization Investigation (BARI): baseline clinical and angiographic data. Am J Cardiol. 1995;75(9):9C–17C. [PubMed: 7892823]
8.
Sutton-Tyrrell K, Rihal C, Sellers MA, et al. Long-term prognostic value of clinically evident noncoronary vascular disease in patients undergoing coronary revascularization in the Bypass Angioplasty Revascularization Investigation (BARI) Am J Cardiol. 1998;81(4):375–81. [PubMed: 9485122]
9.
Mullany CJ, Mock MB, Brooks MM, et al. Effect of age in the Bypass Angioplasty Revascularization Investigation (BARI) randomized trial. Ann Thorac Surg. 1999;67(2):396–403. [PubMed: 10197660]
10.
Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. N Engl J Med. 1996;335(4):217–25. [PubMed: 8657237]
11.
Minai K, Horie H, Takahashi M, et al. Long-term outcome of primary percutaneous transluminal coronary angioplasty for low-risk acute myocardial infarction in patients older than 80 years: a single-center, open, randomized trial. Am Heart J. 2002;143(3):497–505. [PubMed: 11868057]
12.
Stone GW, Grines CL, Browne KF, et al. Comparison of in-hospital outcome in men versus women treated by either thrombolytic therapy or primary coronary angioplasty for acute myocardial infarction. Am J Cardiol. 1995;75(15):987–92. [PubMed: 7747700]
13.
Clayton TC, Pocock SJ, Henderson RA, et al. Do men benefit more than women from an interventional strategy in patients with unstable angina or non-ST-elevation myocardial infarction? The impact of gender in the RITA 3 trial. Eur Heart J. 2004;25(18):1641–50. [PubMed: 15351164]
14.
Fox KA, Poole-Wilson PA, Henderson RA, et al. Interventional versus conservative treatment for patients with unstable angina or non-ST-elevation myocardial infarction: the British Heart Foundation RITA 3 randomised trial. Randomized Intervention Trial of unstable Angina. Lancet. 2002;360(9335):743–51. [PubMed: 12241831]
15.
Cannon CP, Weintraub WS, Demopoulos LA, et al. Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. N Engl J Med. 2001;344(25):1879–87. [PubMed: 11419424]
16.
Glaser R, Herrmann HC, Murphy SA, et al. Benefit of an early invasive management strategy in women with acute coronary syndromes. JAMA. 2002;288(24):3124–9. [PubMed: 12495392]
17.
Cannon CP, Weintraub WS, Demopoulos LA, et al. Invasive versus conservative strategies in unstable angina and non-Q-wave myocardial infarction following treatment with tirofiban: rationale and study design of the international TACTICS-TIMI 18 Trial. Treat Angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy. Thrombolysis In Myocardial Infarction. Am J Cardiol. 1998;82(6):731–6. [PubMed: 9761082]
PubReader format: click here to try

Views

  • PubReader
  • Print View
  • Cite this Page
  • PDF version of this title (1.7M)

Related information

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...