Abstract 15630: Gender-related Differences in the Management of Chronic Coronary Syndrome: Registry Data of a Tertiary Center in Brazil

• Published in: Circulation (New York, N.Y.) N.Y.), 2020-11, Vol.142 (Suppl_3 Suppl 3), p.A15630-A15630
• Main Authors: Serrano, Carlos V, Moreira, Eduardo M, Garzillo, Cibele L, Montenegro, Luiz M, Tabuse, Cindy L, Kormann-Moreira, Mylena C, segre, alexandre W, Bolta, Paula M, Favarato, Desiderio, Pitta, Fabio G, Lima, Eduardo G, Rezende, Paulo H, Hueb, Whady A
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.15630

IntroductionThere is scarce data on sex-related differences in chronic coronary syndrome (CCS) management in low-and-middle-income countries. We aimed to describe those in CCS patients in a tertiary center in Brazil. HypothesisMultiple gender-related differences may affect management of CCS and, subsequently, influence outcome in developing countries - improvement in tertiary care is justified. MethodsPatients from an outpatient clinic with known history of myocardial infarction (MI), coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), or stable angina with documented coronary artery lesions > 50% were evaluated for differences regarding prescription, laboratory data, symptoms and other clinical variables. Patients were deemed to have optimal goal-directed therapy if blood pressure (BP) was < 140/90 mmHg, LDL-cholesterol < 70 mg/dL and were in use of antithrombotics. We also assessed incidence of MI, stroke or death. Results625 patients, 208 (33.3%) women and 417 men, were included. We found no sex-related differences in mean age (65 years, SD 9.6 for the cohort) or in prevalence of previous MI, CABG or PCI. Women had higher systolic BP (134 vs 128 mmHg, p < 0.001), higher left ventricular ejection fraction (56 vs 51%, p < 0.001), lower creatinine clearance (69 vs 73 mL/min, p= 0.04), and higher LDL (103 vs 87 mg/dL, p < 0.001). We found no differences regarding glucose levels, BMI or symptoms. Women were less likely to be prescribed calcium-channel blockers (p = 0.04), but equally likely to be prescribed statins. Gender-related differences in LDL and BP were present even after adjustments. Women were less likely to have optimized goal-directed therapy (14.9% vs 28.3%, p < 0.001), even after adjustments. Gender was not associated with event-free survival on one-year follow-up (97% vs 98%). ConclusionsIn this setting, women had higher LDL-cholesterol, higher SBP, and lower proportion of optimized goal-directed therapy than men, but gender was not related to worse one-year prognosis.