International journal of cardiology · 2017
Gender differences in long-term clinical outcomes and prognostic factors in patients with vasospastic angina.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Lee Da Hyon, Park Taek Kyu, Seong Choong Sil, Gwag Hye Bin, Lim A Young, Oh Min Seok, Cho Sung Woo, Yang Jeong Hoon, Song Young Bin, Hahn Joo-Yong, Choi Jin-Ho, Lee Sang Hoon, Gwon Hyeon-Cheol, Choi Seung-Hyuk
Аннотация
BACKGROUND: Men are more likely to suffer from vasospastic angina (VSA) than women; however, gender differences in the long-term prognosis of VSA patients have not been fully elucidated. We sought to investigate clinical outcomes and predictive factors of VSA patients according to gender.
METHODS: A total of 986 patients (838 men and 148 women) with a positive result on intracoronary ergonovine provocation test between January 2003 and December 2014 were analyzed. The primary outcome was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction, revascularization, or rehospitalization due to recurrent angina.
RESULTS: Women were younger and showed a lower prevalence of smoking or fixed coronary stenosis than men. The risk for MACE was similar between male and female patients (hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.65-1.39; p=0.79). In multivariable prediction models for MACE, high-sensitivity C-reactive protein (hs-CRP) level was a significant predictor of MACE in male patients (HR, 1.95; 95% CI, 1.25-3.06; p=0.003), but there was no significant predictor in female patients. There was a significant interaction between hs-CRP level and MACE rate across genders (interaction p=0.02).
CONCLUSIONS: Long-term clinical outcome was not different between genders. Hs-CRP was an important predictor of long-term clinical outcomes in male patients with VSA, but not in female patients.
METHODS: A total of 986 patients (838 men and 148 women) with a positive result on intracoronary ergonovine provocation test between January 2003 and December 2014 were analyzed. The primary outcome was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction, revascularization, or rehospitalization due to recurrent angina.
RESULTS: Women were younger and showed a lower prevalence of smoking or fixed coronary stenosis than men. The risk for MACE was similar between male and female patients (hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.65-1.39; p=0.79). In multivariable prediction models for MACE, high-sensitivity C-reactive protein (hs-CRP) level was a significant predictor of MACE in male patients (HR, 1.95; 95% CI, 1.25-3.06; p=0.003), but there was no significant predictor in female patients. There was a significant interaction between hs-CRP level and MACE rate across genders (interaction p=0.02).
CONCLUSIONS: Long-term clinical outcome was not different between genders. Hs-CRP was an important predictor of long-term clinical outcomes in male patients with VSA, but not in female patients.