Sex-based Prognostic Implications of Nonobstructive Coronary Artery Disease: Results from the International Multicenter CONFIRM Study
Key result
Women and men with nonobstructive CAD experience identical MACE risk.
- P=.94
- n=11,462
Why the study?
The clinical outcomes of women and men with nonobstructive coronary artery disease matched for risk factors, angina typicality, and disease extent were unclear.
Do women and men with similar nonobstructive CAD extent and risk factors have different rates of incident MACE?
Population
11,462 propensity-matched patients with no or nonobstructive CAD undergoing coronary CT angiography at 12 centers
Comparison
Women vs men matched for age, CAD risk factors, angina typicality, and CAD extent and distribution
Design
Prospective international multicenter cohort study
Follow-up
Mean 2.3 years ± 1.1
Authors
Discussion
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Implication
Matched women and men with nonobstructive CAD show comparable MACE rates; supports similar prognostic value by sex when extent is matched but leaves open prospective validation.
Study Design
Type
Cohort (n=11,462)
Multicenter
Yes
Structured PICO
Do women and men with similar nonobstructive CAD extent and risk factors have different rates of incident MACE?
P
Population
11,462 propensity-matched men and women with no or nonobstructive (<50% stenosis) coronary artery disease undergoing coronary CT angiography, followed for a mean of 2.3 years.
E
Exposure
Female sex
C
Comparator
Male sex (propensity matched for age, CAD risk factors, angina typicality, and CAD extent/distribution)
O
Outcome
Incident major adverse cardiovascular events (MACE), inclusive of death and myocardial infarctioncomposite
Main Result
Absolute Event Rate: 0.6% vs 0.6%
p-value: p=.94
When matched for risk factors and disease extent, women and men with nonobstructive CAD have comparable rates of incident mortality and myocardial infarction.
Cite This Study
Leipsic et al. (2014) conducted a cohort in Nonobstructive coronary artery disease (n=11,462). Female sex vs. Male sex was evaluated on Major adverse cardiovascular events (MACE) (p=.94). Women and men with nonobstructive coronary artery disease experienced identical annualized rates of MACE (0.6% vs 0.6%, P=0.94), with nonobstructive CAD similarly increasing risk in both sexes.