000			05242nam a22006857a 4500
008			171110s20172017 xxu||||| |||| 00| 0 eng d
040			_aOvid MEDLINE(R)
099			_a29049508
245			_aOutcomes in Women and Minorities Compared With White Men 1 Year After Everolimus-Eluting Stent Implantation: Insights and Results From the PLATINUM Diversity and PROMUS Element Plus Post-Approval Study Pooled Analysis.
251			_aJAMA Cardiology. 2(12):1303-1313, 2017 12 01.
252			_aJAMA Cardiol. 2(12):1303-1313, 2017 12 01.
253			_aJAMA cardiology
260			_c2017
260			_fFY2018
266			_d2017-11-10
520			_aConclusions and Relevance: After contemporary everolimus-eluting stent implantation, women and minorities experience a similar risk of 1-year MACE but a higher adjusted risk of recurrent ischemic events primarily because of nonstent-related MIs. Both clinical and angiographic factors and social determinants of health, including widowhood and insurance status, contribute to 1-year MACE among women and minorities.
520			_aDesign, Settings, and Participants: The PLATINUM Diversity study was a single-arm study enrolling women and minorities. Patient-level pooling with the PROMUS Element Plus Post-Approval Study was prespecified. Data on social determinants of health and language were collected in the PLATINUM Diversity cohort, which included 1501 patients at 52 US sites. The PROMUS Element Plus Post-Approval study enrolled 2681 patients at 52 US sites with some site overlap and included an "all-comers" population. All patients were enrolled beginning in October 2014 and were followed for 12 months. Analyses began in August 2016.
520			_aImportance: There exist limited outcomes data for women and minorities after contemporary percutaneous coronary intervention (PCI).
520			_aInterventions: Patients received 1 or more everolimus-eluting stent implantation.
520			_aMain Outcomes and Measures: The primary end point was 1-year major adverse cardiac events (MACE), which included death/myocardial infarction (MI)/target vessel revascularization. Secondary ischemic end points were also evaluated.
520			_aObjective: To examine 1-year outcomes in women and minorities vs white men after PCI with everolimus-eluting stents.
520			_aResults: The pooled study consisted of 4182 patients: 1635 white men (39.1%), 1863 women (white and minority) (44.5%), and 1059 minority patients (women and men) (25.3%). Women and minorities had a higher prevalence of diabetes, prior stroke, hypertension, renal disease, and congestive heart failure than white men but lower rates of multivessel disease, prior coronary artery bypass graft surgery, prior MI, and smoking. Unadjusted 1-year MACE rates (white men, 7.6%; women, 8.6%; minorities, 9.6%) were similar between groups with no significant differences after risk adjustment. The adjusted risk of death/MI was higher among women (odds ratio, 1.6; 95% CI, 1.1-2.4) and minorities (odds ratio, 1.9; 95% CI, 1.2-2.8) compared with white men and the adjusted risk of MI was higher in minorities (odds ratio, 2.6; 95% CI, 1.4-4.8). These differences were driven primarily by nonstent-related MIs. Within the PLATINUM Diversity cohort, the independent predictors of MACE were cardiogenic shock, renal disease, history of peripheral vascular disease, multivessel disease, widowhood, and lack of private insurance.
546			_aEnglish
650			_a*Cardiovascular Diseases/mo [Mortality]
650			_a*Coronary Artery Disease/su [Surgery]
650			_a*Drug-Eluting Stents
650			_a*Ethnic Groups
650			_a*Minority Groups
650			_a*Myocardial Infarction/ep [Epidemiology]
650			_a*Myocardial Revascularization/sn [Statistics & Numerical Data]
650			_a*Percutaneous Coronary Intervention
650			_aAfrican Americans/sn [Statistics & Numerical Data]
650			_aAged
650			_aAlaska Natives/sn [Statistics & Numerical Data]
650			_aCoronary Angiography
650			_aCoronary Artery Disease/dg [Diagnostic Imaging]
650			_aEverolimus/ad [Administration & Dosage]
650			_aFemale
650			_aHispanic Americans/sn [Statistics & Numerical Data]
650			_aHumans
650			_aImmunosuppressive Agents/ad [Administration & Dosage]
650			_aIndians, North American/sn [Statistics & Numerical Data]
650			_aInsurance, Health
650			_aLogistic Models
650			_aMale
650			_aMiddle Aged
650			_aOdds Ratio
650			_aProspective Studies
650			_aSex Factors
650			_aSocial Determinants of Health
650			_aTreatment Outcome
650			_aUnited States/ep [Epidemiology]
650			_aWidowhood
651			_aMedStar Union Memorial Hospital
657			_aJournal Article
700			_aWang, John
790			_aBatchelor W, Chandrasekhar J, Davis S, Gigliotti OS, Giugliano G, Haghighat A, Horwitz PA, Kandzari DE, Lopez M, Mehran R, Othman I, Singh S, Tami L, Thompson CA, Underwood P, Wang JC
856			_uhttps://dx.doi.org/10.1001/jamacardio.2017.3802 _zhttps://dx.doi.org/10.1001/jamacardio.2017.3802
942			_cART _dArticle
999			_c2813 _d2813