This article is more than 5 years old. Information may no longer be current.
Women with obstructive CAD have high rate of angina readmission, adverse events
Click Here to Manage Email Alerts
Among patients with evidence of obstructive CAD, women have worse outcomes than men. The differences are most pronounced in patients with ACS and are consistent across ethnicities, according to results of a recent study.
Researchers performed a population-based cohort study of 49,556 adults (25% women) from British Columbia, Canada, with ACS or stable angina (66% ACS) and angiographic evidence of obstructive CAD, defined as 50% stenosis. Ethnicity breakdown was 9.5% South Asian, 3% Chinese and 87.5% other (primarily white).
The outcome of interest was a composite of all-cause death and hospital readmission for MI, HF, cerebrovascular accident or angina at 2 years following the index angiography.
Over time, women were more likely to experience the outcome of interest than men regardless of ethnicity (log-rank P < .001 for ACS and stable angina; P for interaction between sex differences and ethnicity = .64), according to the results.
The researchers observed no interaction between sex, ethnicity and clinical presentation (P for interaction = .59).
In an unadjusted model, the magnitude of the disparity between sexes was greater in those with ACS (P for interaction = .03), but lost significance after adjustment for demographic and clinical characteristics (P for interaction = .32).
In the ACS group, the adjusted HRs for women vs. men were 1.37 (95% CI, 1.19-1.57) for South Asians, 1.59 (95% CI, 1.22-2.08) for Chinese and 1.32 (95% CI, 1.26-1.39) for others. In the stable angina group, the adjusted HRs for women vs. men were 1.3 (95% CI, 1.12-1.52) for South Asians, 1.51 (95% CI, 1.15-1.99) for Chinese and 1.26 (95% CI, 1.15-1.38) for others.
Women were more likely than men to be readmitted for angina (OR = 1.13; 95% CI, 1.04-1.22), which accounted for 45% of the composite outcome, and angina was the most frequent occurrence of the composite outcome in all subgroups except Chinese women with ACS, according to the researchers.
Mona Izadnegahdar
“Our findings highlight the need for targeted interventions to reduce the burden of angina in this population, as this presentation is clearly not benign,” Mona Izadnegahdar, PhD, from the department of cardiology at the University of British Columbia, Vancouver, and colleagues wrote. – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts