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Coronary heart disease in women: less extensive disease and improved long-term survival compared to men
1Feiring Heart Clinic, Feiring, Norway. moelsta@online.no
Insights
Women undergoing coronary angiography had less severe coronary artery disease than men. Despite this, women experienced significantly better long-term survival rates, even after adjusting for other health factors.
Area of Science:
- Cardiology
- Clinical Medicine
- Public Health
Background:
- Coronary artery disease (CAD) affects millions globally, with documented sex-based differences in presentation and outcomes.
- Understanding these disparities is crucial for equitable cardiovascular care and risk stratification.
Purpose of the Study:
- To compare the extent of coronary artery disease (CAD) in women versus men undergoing coronary angiography.
- To evaluate long-term survival differences between women and men after adjusting for baseline demographics and comorbidities.
Main Methods:
- Analysis of 18,767 patients who underwent coronary angiography between March 1999 and December 2006.
- Survival status ascertained through the Norwegian National Registry up to May 2007.
- Age-stratified analyses and Cox regression models were used to adjust for baseline differences.
Main Results:
- Women had significantly less coronary disease (no CAD: 28.7% vs. 10.5%) and men had more three-vessel disease (38.7% vs. 21.8%) upon angiography (p <0.001).
- Covariate-adjusted survival was significantly better in women (hazard ratio: 1.29; p <0.001).
- No significant survival difference was observed in the subgroup with high left ventricular end-diastolic pressure.
Conclusions:
- Women referred for invasive examination presented with less extensive coronary artery disease compared to men.
- Women demonstrated improved long-term survival post-angiography when baseline differences were statistically controlled.
Objectives:
The aim of the study was to compare extent of coronary disease and subsequent long-term survival in women compared to men adjusted for baseline differences in demographics and morbidity.
Design:
In the database at Feiring Heart Clinic 18 767 patients had a coronary angiographic examination in the period from March 1999 to December 31, 2006. Their survival status as of May 31, 2007 was ascertained through the Norwegian National Registry. Survival was compared using age stratified analyses and Cox regression adjusting for baseline differences.
Results:
Significantly more women than men had no coronary disease (28.7 vs. 10.5%, p <0.001), while three vessel disease was more frequently present in men (38.7 vs. 21.8%, p <0.001), as judged by coronary angiography. Covariate adjusted survival was significantly better in women compared to men with an overall hazard ratio of 1.29 (p <0.001), but with no significant difference in the subgroup with high left ventricular end diastolic pressure.
Conclusions:
At the time of referral to invasive examination women had less extensive coronary artery disease than men as judged by coronary angiography and improved long-term survival when baseline differences were accounted for.
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