With diabetes, women do worse after stenting

When people with diabetes undergo coronary artery stenting to open clogs, women are more at risk for major adverse events than men, doctors in Germany report.

In particular, re-clogging of the arteries is more likely to occur among women.

Consequently, diabetic women may benefit even more than diabetic men from coronary bypass surgery, as well as from anti-platelet drugs or drug-eluting stents to prevent re-clogging, Dr. Gjin Ndrepepa and colleagues suggest.

Ndrepepa's group, at Technischen Universitat Munich, followed 4460 patients who underwent coronary artery stenting for angina between 1995 and 2000. The group included 658 men and 312 women who had diabetes.

Six months after the stent procedure, women with diabetes were 50 percent more likely to see their arteries re-clog than nondiabetic women, but this was not the case for diabetic and nondiabetic men, the team reports in the American Journal of Medicine.

The cumulative rate of death, heart attack, and need for another procedure after one year was also 50 percent higher in women with diabetes than those without. For men, the increased risk with diabetes was only 7 percent.

Diabetes seems to accentuate menopause-related vascular alterations, Ndrepepa's team proposes, and this may heighten a woman's propensity to form blood clots.

SOURCE: American Journal of Medicine, December 1, 2004.