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The stress echo prognostic gender gap.

L Cortigiani1, G Gigli, A Vallebona

  • 1Cardiovascular Research Foundation, Castelfranco Veneto (Treviso), Italy.

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|March 8, 2002
PubMed
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Female gender independently predicts cardiac events in patients experiencing myocardial ischemia during stress echocardiography. Women show lower 5-year infarction-free survival compared to men, highlighting a significant prognostic difference.

Area of Science:

  • Cardiology
  • Echocardiography
  • Clinical Prognosis

Background:

  • Pharmacological stress echocardiography is used to evaluate coronary artery disease.
  • Prognostic differences in myocardial ischemia between sexes are not fully understood.

Purpose of the Study:

  • To investigate if myocardial ischemia during stress echocardiography has a different prognosis in men versus women.
  • To identify independent predictors of cardiac events in patients with stress-induced ischemia.

Main Methods:

  • A study of 1733 patients (941 men, 792 women) undergoing dipyridamole or dobutamine stress echocardiography.
  • Analysis of cardiac events, deaths, infarctions, and revascularizations over a median follow-up of 25 months for the ischemic group.
  • Multivariate analysis to identify independent predictors of cardiac events, including gender, age, and echocardiographic parameters.

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Main Results:

  • Myocardial ischemia was detected in 460 patients; women were older and had more comorbidities.
  • Female gender was an independent predictor of cardiac events in the entire ischemic population and in those with suspected coronary artery disease (CAD).
  • Five-year infarction-free survival was significantly lower in women (71%) compared to men (82%) within the ischemic groups.

Conclusions:

  • Female gender is an independent predictor of adverse cardiac events in patients with pharmacologically induced myocardial ischemia.
  • Stress echocardiography reveals sex-specific prognostic differences in patients with coronary artery disease.
  • These findings underscore the importance of considering gender in risk stratification for patients with ischemic heart disease.