Women with CAD-related sudden cardiac arrest were older, had fewer prior MIs and less multi-vessel disease (57.5% vs 64.2%) but more non-obstructive MI (22.5% vs 17.7%) than men.
Do the clinical and angiographic characteristics of CAD-related sudden cardiac arrest differ between women and men?
Women experiencing CAD-related sudden cardiac arrest present with less severe obstructive coronary disease and more non-obstructive myocardial infarction compared to men, suggesting different underlying pathophysiological mechanisms.
Absolute Event Rate: 0% vs 0%
Abstract Background There is very limited information regarding sex differences in Sudden Cardiac Arrest (SCA) related to coronary artery disease (CAD), encompassing both acute ischemia and chronic substrate. Methods We combined data from two prospective, population-based studies that capture exhaustive data: the Paris-SDEC registry in France (survivors to hospital admission) and the Fingesture study in Finland (non-survivors to hospital admission). This analysis focused on CAD, as adjudicated by both forensic and clinical data following SCA, with findings stratified by sex. Results Out of 10,253 cases of SCA, 6,203 (60.5%) were CAD-related, including 1,197 (19.3%) in women. Compared to men, women were older (68.3 vs 63.1yo, p=0.001), have few prior history of myocardial infarction or percutaneous coronary intervention (8.4 vs. 12.0%, p0.001), and present similar proportion with ≥one cardiovascular risk factor profile (59.6 vs. 62.2%, p=0.10). Women with CAD-related SCA presented lower proportions of two/ three vessel disease (57.5% vs 64.2% in men, p=0.001), while non-obstructive myocardial infarction was more frequent in women (22.5 vs. 17.7%, p0.001). No difference was found regarding the location of coronary lesion, most acute CAD-related SCA cases presenting with culprit lesion on the left anterior descending artery (61.4%). When comparing survivors to deceased cases, CAD was more severe among deceased on the field compared to admitted alive patients (15.8% three-vessel disease in women admitted alive vs 26.0% in women deceased on the field, 26.3% and 53.3% respectively in men). Conclusion CAD-related SCA exhibits distinctive characteristics in women compared to men, suggesting that different mechanisms involving plaque rupture and pathophysiology may be at play and warrant further investigation.
Weizman et al. (Sat,) reported a other. Women with CAD-related sudden cardiac arrest were older, had fewer prior MIs and less multi-vessel disease (57.5% vs 64.2%) but more non-obstructive MI (22.5% vs 17.7%) than men.