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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.)
This publication is provided for historical reference only and the information may be out of date.
Table G-1Summary of RCTs reporting modifiers of effectiveness (subgroup analyses)
| Study Author/Year Related Articles | Population | Comparison | # Subjects | Subgroup Analyses | Quality |
|---|---|---|---|---|---|
| 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. CABG | Total: 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., 200211 | STEMI age ≥ 80 years | PCI vs conservative/supportive therapy | Total: 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 | STEMI | PCI 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/NSTEMI | Early invasive (PCI) vs. initial conservative | Total: 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/NSTEMI | Early invasive (PCI) vs. initial conservative | Total: 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.
- Anonymous. 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.
- Anonymous. 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.
- Anonymous. 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]
- Summary Table for Modifiers of Effectiveness - Treatment Strategies for Women Wi...Summary Table for Modifiers of Effectiveness - Treatment Strategies for Women With Coronary Artery Disease
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