Women with angina pectoris had greater improvement in SAQ-SS over 12 months (OR 1.4, 95% CI 1.09–1.81) despite lower baseline scores and less revascularization.
Does female sex predict different health status trajectories compared to male sex in Chinese patients with angina pectoris?
Despite having lower baseline health status and lower rates of revascularization, women with angina pectoris experience greater improvements in health status over 12 months compared to men.
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Abstract Background Angina pectoris (AP) significantly impacts health-related quality of life. However, sex-based differences in health status trajectories for patients with AP in real-world Chinese cohorts remain underexplored. Purpose To evaluate sex-based differences in health status trajectories among Chinese patients with AP, with implications for personalised care. Methods This post-hoc analysis utilised data from the GREAT registry, a multicentre, prospective, observational study. Patients were stratified by sex, and health status was assessed using the Seattle Angina Questionnaire (SAQ) at baseline, 3, 6, 9, and 12 months. Changes in the SAQ summary score (SAQ-SS) and its domains were analysed using linear mixed-effects models to identify sex-based differences in health status trajectories. Logistic regression analysis was used to evaluate sex differences in achieving clinically meaningful improvement (defined as a SAQ-SS increase ≥ 10 points) at 12 months across various subgroups. Results A total of 1,556 patients with AP (1,112 men and 444 women) were included. At baseline, women had significantly lower SAQ-SS compared to men (59.52 ± 12.93 vs. 62.64 ± 12.61, P 0.001), despite a lower prevalence of extensive coronary involvement (≥ 2-vessel disease: 61.7% vs. 73.7%, P = 0.01). Women also had lower revascularisation rates during index hospitalisation (38.3% vs 50.6%, P 0.001). Long-term medication adherence was similar between sexes (P ≥ 0.05). By 12 months, both sexes achieved comparable SAQ-SS (77.65 ± 7.82 vs. 77.68 ± 7.03, P = 0.94). The linear mixed-effects model revealed that women exhibited greater improvement in health status over time compared to men, with consistent results across most SAQ domains (P for interaction 0.001), except for the angina frequency domain (P for interaction = 0.08) (Figure 1). Logistic regression identified female sex as an independent predictor of clinically meaningful improvement in SAQ-SS (OR: 1.4, 95% CI: 1.09–1.81, P = 0.01), after adjusting for age, coronary artery involvement, coronary revascularization, and anti-angina medication use. Subgroup analyses showed that women experienced greater clinically meaningful improvements in SAQ-SS across several groups, including those aged 65 years, with hypertension, without diabetes, with unstable angina, not undergoing coronary revascularisation, and not using nitrates or nicorandil (all P 0.05) (Figure 2). Conclusion Significant sex differences exist in health status trajectories among Chinese patients with AP, with women showing greater improvements over time in the natural course of treatment. These findings suggest that women may benefit more from proactive treatment strategies.
Wu et al. (Sat,) reported a other. Women with angina pectoris had greater improvement in SAQ-SS over 12 months (OR 1.4, 95% CI 1.09–1.81) despite lower baseline scores and less revascularization.