Among patients with stable chest pain aged ≤59 years, normal CAD was more prevalent in women than men (78.8% vs 42.3%, P<0.001), and fewer high-risk women were prescribed aspirin (83.0% vs 86.1%).
Observational (n=12,200)
Yes
Are there sex differences in the appropriateness of cardiovascular medication use and coronary angiography findings among patients with stable chest pain?
Women with stable chest pain referred for angiography are significantly more likely to have non-obstructive CAD and less likely to receive guideline-directed aspirin therapy compared to men, highlighting a need for improved risk stratification.
Absolute Event Rate: 78.8% vs 42.3%
p-value: p=<0.001
AIMS: The main purpose of the present study was to analyse the contemporary use of cardiovascular medications and diagnostic coronary angiography in men and women with suspected coronary artery disease (CAD). Furthermore, we examined the association of outcomes (death, myocardial infarction, repeat coronary angiography, procedural complications) with angiographic findings. METHODS: All patients with stable chest pain (n = 12 200) referred for a first-time elective diagnostic coronary angiography during 2006-08 and registered in the Swedish Coronary Angiography and Angioplasty Register (SCAAR) were included. Significant CAD was defined as ≥ 50% luminal narrowing in any epicardial coronary artery. RESULTS: In the youngest age group (≤ 59 years), more women than men (78.8 vs. 42.3%, P< 0.001) had normal/non-significant CAD, whereas more men had either left-main or three-vessel disease (18.2 vs. 4.2%, P < 0.001). Event rates were similarly low for men and women with normal/non-significant CAD, except for a higher procedural complication rate in women. Prior to angiography, fewer women than men with high-risk features were prescribed aspirin (83 vs. 86.1%, P = 0.001). CONCLUSION: In women, normal/non-significant CAD was highly prevalent, especially among younger women, and associated cardiovascular event rates were low. In men, findings of advanced disease were more common than in women, even younger men. Fewer high-risk women than men were initially prescribed aspirin. The observed sex differences suggest a need for improved identification of women appropriate for investigation with coronary angiography, earlier diagnostics in men, and heightened attention in the evidence-based use of aspirin in risk patients, especially women.
Johnston et al. (Thu,) conducted a observational in suspected coronary artery disease (CAD) (n=12,200). Female sex vs. Male sex was evaluated on Normal/non-significant CAD in patients ≤ 59 years (p=<0.001). Among patients with stable chest pain aged ≤59 years, normal CAD was more prevalent in women than men (78.8% vs 42.3%, P<0.001), and fewer high-risk women were prescribed aspirin (83.0% vs 86.1%).