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- Title
Long-Term Prognostic Impact of Sex in Patients with Chronic Coronary Syndrome: A 17-Year Prospective Cohort Study.
- Authors
Ruiz-Ortiz, Martín; Sánchez-Fernández, Carlos; Sánchez-Fernández, José J.; Mateos-de-la-Haba, Leticia; Barreiro-Mesa, Lucas; Ogayar-Luque, Cristina; Romo-Peñas, Elías; Delgado-Ortega, Mónica; Rodríguez-Almodóvar, Ana; Esteban-Martínez, Fátima; López-Aguilera, José; Carrasco-Ávalos, Francisco; Castillo-Domínguez, Juan C.; Anguita-Sánchez, Manuel; Pan, Manuel; Mesa-Rubio, Dolores
- Abstract
Background: Women and men with chronic coronary syndrome (CCS) have different clinical features and management, and studies on mid-term prognosis have reported conflicting results. Our objective was to investigate the impact of the female sex in the prognosis of the disease in the very long term. Methods and Results: We investigated differential features and very long-term prognosis in 1268 consecutive outpatients with CCS (337 [27%] women and 931 [73%] men). Women were older than men, more likely to have hypertension, diabetes, angina, and atrial fibrillation, and less likely to be exsmoker/active smoker and to have been treated with coronary revascularization (p < 0.05 for all). The prescription of statins, antiplatelets, and betablockers was similar in both groups. After up to 17 years of follow-up (median = 11 years, interquartile range = 4–15 years), cumulative incidences of acute myocardial infarction (10.2% vs. 11.8%) or stroke (11% vs. 10%) at median follow-up were similar, but the risks of major cardiovascular events (acute myocardial infarction, stroke, or cardiovascular death, 41.2% vs. 33.6%), hospital admission for heart failure (20.9% vs. 11.9%), or cardiovascular death (32.3% vs. 22.1%) were significantly higher for women (p < 0.0005), with a nonsignificant trend to higher overall mortality (45.2% vs. 39.1%, p = 0.07). However, after multivariate adjustment, all these differences disappeared. Conclusion: Although women and men with CCS presented a different clinical profile, and crude rates of major cardiovascular events, heart failure and cardiovascular death were higher in women, female sex was not an independent prognostic factor in this study with up to 17 years of follow-up.
- Subjects
MYOCARDIAL infarction risk factors; STROKE risk factors; MYOCARDIAL infarction-related mortality; CHRONIC diseases; MAJOR adverse cardiovascular events; MULTIVARIATE analysis; PATIENTS; SEX distribution; HOSPITAL admission &; discharge; CORONARY artery disease; SURVIVAL analysis (Biometry); DESCRIPTIVE statistics; WOMEN'S health; LONGITUDINAL method; HEART failure
- Publication
Journal of Women's Health (15409996), 2023, Vol 32, Issue 1, p63
- ISSN
1540-9996
- Publication type
Article
- DOI
10.1089/jwh.2022.0058