CORRESPONDENCE: LETTERS TO THE EDITOR
Is aspirin resistance or female gender associated with a high incidence of myonecrosis after nonurgent percutaneous coronary intervention? Reply
Wai-Hong Chen, MBBS*,
Pui-Yin Lee, MBBS,
William Ng, MBBS,
Hung-Fat Tse, MD and
Chu-Pak Lau, MD
* Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China (Email: whchen{at}hku.hk).
We would like to thank Dr. Poulsen and colleagues for their interest in our study (1). The prevalence of female gender with or without creatine kinase-myocardial band (CK-MB) elevation after percutaneous coronary intervention (PCI) was not different between the two groups (31.1% vs. 21.7%; p = 0.22). Gender was entered in the multivariate analysis, and it turned out not to be an independent predictor of CK-MB elevation.
Women undergoing balloon angioplasty had a higher incidence of early adverse cardiac events in both early (2) and contemporary series (3). In the current era of predominant stent implantation for PCI, mixed results have been demonstrated (4–6). However, our data concur with recent studies specifically addressing post-PCI myonecrosis, in which female gender is not demonstrated to be an independent correlate of post-PCI myonecrosis (7–9).
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1. Chen WH, Lee PY, Ng W, et al. Aspirin resistance is associated with a high incidence of myonecrosis after non-urgent percutaneous coronary intervention despite clopidogrel pretreatment J Am Coll Cardiol 2004;43:1122-1126.[Abstract/Free Full Text]
2. Cowley MJ, Mullin SM, Kelsey SF, et al. Sex differences in early and long-term results of coronary angioplasty in the NHLBI PTCA registry Circulation 1985;71:90-97.[Abstract/Free Full Text]
3. Kelsey SF, James M, Hloubkov R, et al. Results of percutaneous transluminal coronary angioplasty in women1985–1986 National Heart, Lung, and Blood Institute's Coronary Angioplasty Registry. Circulation 1993;87:720-727.[Abstract/Free Full Text]
4. Mehilli J, Kastrati A, Dirschinger J, et al. Differences in prognostic factors and outcomes between women and men undergoing coronary artery stenting JAMA 2000;284:1799-1805.[Abstract/Free Full Text]
5. Watanabe CT, Maynard C, Ritchie JL. Comparison of short-term outcomes following coronary artery stenting in men versus women Am J Cardiol 2001;88:848-852.[CrossRef][Web of Science][Medline]
6. Trabattoni D, Bartorelli AL, Montorsi P, et al. Comparison of outcomes in women and men treated with coronary stent implantation Catheter Cardiovasc Interv 2003;58:20-28.[CrossRef][Web of Science][Medline]
7. Kini A, Marmur JD, Kini S, et al. Creatine kinase-MB elevation after coronary intervention correlates with diffuse atherosclerosis, and low-to-medium level elevation has a benign clinical course J Am Coll Cardiol 1999;34:663-671.[Abstract/Free Full Text]
8. Stone GW, Mehran R, Gangas G, et al. Differential impact on survival of electrocardiographic Q-wave versus enzymatic myocardial infarction after percutaneous intervention: a device-specific analysis of 7,147 patients Circulation 2001;104:642-647.[Abstract/Free Full Text]
9. Kini AS, Lee P, Mitre CA, et al. Postprocedure chest pain after coronary stenting: implications on clinical restenosis J Am Coll Cardiol 2003;41:33-38.[Abstract/Free Full Text]
Related Article
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Is aspirin resistance or female gender associated with a high incidence of myonecrosis after nonurgent percutaneous coronary intervention?
- Tina S. Poulsen, Anders Kastrup, and Hans Mickley
J. Am. Coll. Cardiol. 2005 45: 635-636.
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