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Published on: January 28, 2020
Women and men with stable coronary artery disease have similar clinical outcomes: insights from the international
Ph Gabriel Steg1, Nicola Greenlaw, Jean-Claude Tardif
1INSERM U698, Paris, France. gabriel.steg@bch.ap-hop-paris.fr
European Heart Journal
|August 28, 2012
Summary
Outcomes for men and women with stable coronary artery disease (CAD) were similar after one year, despite differences in risk factors and treatment. However, women underwent fewer revascularization procedures, highlighting a need for further research into gender-specific care.
Area of Science:
- Cardiology
- Clinical Outcomes
- Gender Differences in Medicine
Background:
- Men and women present and are managed differently for coronary artery disease (CAD).
- Existing data on whether these differences impact clinical outcomes in stable CAD is limited.
- The CLARIFY registry provides a large international dataset to investigate these disparities.
Purpose of the Study:
- To compare cardiovascular clinical outcomes between men and women with stable CAD.
- To analyze differences in risk profiles, management, and treatment utilization.
- To identify potential gender-based disparities in stable CAD outcomes.
Main Methods:
- Analysis of data from the international prospective CLARIFY registry.
- Inclusion of 30,977 outpatients with stable CAD (77.4% men, 22.6% women).
- Comparison of 1-year composite cardiovascular outcomes, all-cause death, myocardial infarction, and stroke, with adjusted odds ratios and confidence intervals.
Main Results:
- Women were older, had higher rates of hypertension and diabetes, and lower rates of exercise and smoking compared to men.
- Despite more frequent angina in women, they underwent less non-invasive testing and coronary angiography.
- One-year outcomes for the composite of cardiovascular death, non-fatal myocardial infarction, or stroke were similar (adjusted OR 0.93; 95% CI 0.75-1.15).
- All-cause death, myocardial infarction, and cardiovascular death or non-fatal myocardial infarction rates were also comparable between genders.
- Fewer women (2.2%) underwent revascularization compared to men (2.6%) (adjusted OR 0.77; 95% CI 0.64-0.93).
Conclusions:
- Significant differences exist in the risk profiles of men and women with stable CAD.
- Despite these differences, 1-year clinical outcomes were similar between genders.
- Women with stable CAD underwent revascularization less frequently than men.
- Further research is warranted to understand gender determinants of outcomes and address potential biases in the management of women with CAD.
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