Key result
Male sex was associated with a higher unadjusted 12-month rate of the composite cardiovascular endpoint compared to female sex (10.2% vs 7.4%), but was not an independent predictor in multivariable analysis (HR 1.08).
Why the study?
The prognosis of men and women with chronic coronary syndromes remains ambiguous.
Does sex independently predict the 12-month composite outcome of death, MI, ACS-driven revascularization, unstable angina, or stroke in patients with chronic coronary syndromes?
Observational (n=11,021)
No
Does sex independently predict the 12-month composite outcome of death, MI, ACS-driven revascularization, unstable angina, or stroke in patients with chronic coronary syndromes?
Hazard Ratio: 1.08 (95% CI 0.89–1.31)
Absolute Event Rate: 10.2% vs 7.4%
p-value: p=0.45
Although men with chronic coronary syndromes have higher crude rates of adverse cardiovascular events at 12 months, sex is not an independent predictor of outcomes after adjusting for baseline clinical and angiographic differences.
Adjusted analyses show no independent sex effect; leaves open whether baseline differences drive crude rates in chronic coronary syndromes.
BACKGROUND: The prognosis of men and women with chronic coronary syndromes (CCS) remains ambiguous. AIMS: This study aimed to compare the clinical characteristics and 12‑month prognosis of women and men with CCS included in the prospective single‑center registry. METHODS: The study was based on the Prospective Registry of Stable Angina Management and Treatment (PRESAGE) including 11 021 patients with CCS hospitalized between 2006 and 2016 and subjected to coronary angiography. The composite endpoint included all‑cause death, nonfatal myocardial infarction, acute coronary syndrome with revascularization, unstable coronary artery disease, or stroke. RESULTS: Women were older than men (mean [SD] age, 66.6 [9] vs 63.5 [9.6] years; P <0.001). Arterial hypertension (85.8% vs 79%; P <0.001) and type 2 diabetes (38.2% vs 33.7%; P <0.001) were more often diagnosed in women compared with men. Multivessel disease or left main disease were more frequent in men. Percutaneous coronary intervention and coronary artery bypass grafting were more often performed in men than in women (47.1% vs 36%, P <0.001 and 10.6% vs 6.1%, P <0.001, respectively). At 12‑month follow‑up, the composite endpoint was more frequently reached in men (7.4% vs 10.2%; P <0.001), including death (3.3% vs 4.5%; P = 0.002). In multivariable analysis, sex was not an independent predictor of the composite endpoint (hazard ratio, 1.08; 95% CI, 0.89-1.31, P = 0.45). CONCLUSIONS: Women and men with CCS differ in terms of the incidence of risk factors and revascularization treatments received. In men, a higher frequency of death and the composite endpoint was noted at 12‑month follow‑up. However, sex was not an independent predictor of patient outcomes at 12 months.
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Duda-Pyszny et al. (2021) conducted an observational in Chronic coronary syndromes (n=11,021). Male sex vs. Female sex was evaluated on 12-month composite endpoint (all-cause death, nonfatal myocardial infarction, acute coronary syndrome-driven revascularization, unstable angina, or stroke) (HR 1.08, 95% CI 0.89-1.31, p=0.45). Male sex was associated with a higher unadjusted 12-month rate of the composite cardiovascular endpoint compared to female sex (10.2% vs 7.4%), but was not an independent predictor in multivariable analysis (HR 1.08).
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