Women Undergoing Coronary Angiography for Myocardial Infarction or Who Present With Multivessel Disease Have a Poorer Prognosis Than Men

• Published in: Angiology 2016-07, Vol.67 (6), p.571-581
• Main Authors: Gijsberts, Crystel M., Santema, Bernadet T., Asselbergs, Folkert W., de Kleijn, Dominique P. V., Voskuil, Michiel, Agostoni, Pierfrancesco, Cramer, Maarten J., Vaartjes, Ilonca, Hoefer, Imo E., Pasterkamp, Gerard, den Ruijter, Hester M.
• Format: Article
• Language: English
• Subjects: Case-Control Studies; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Coronary Artery Disease - therapy; Female; Health Status Disparities; Humans; Incidence; Kaplan-Meier Estimate; Longitudinal Studies; Male; Multivariate Analysis; Netherlands - epidemiology; Non-ST Elevated Myocardial Infarction - diagnostic imaging; Non-ST Elevated Myocardial Infarction - mortality; Non-ST Elevated Myocardial Infarction - therapy; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Risk Factors; Sex Factors; ST Elevation Myocardial Infarction - diagnostic imaging; ST Elevation Myocardial Infarction - mortality; ST Elevation Myocardial Infarction - therapy; Time Factors
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/0003319715604762

Background: Coronary artery disease affects both men and women. In this study, we examine sex-specific differences in occurrence of major adverse cardiovascular events (MACEs) after coronary angiography. Methods: We analyzed data from the coronary angiography cohort Utrecht Coronary Biobank (n = 1283 men, 480 women). Using Kaplan-Meier and multivariable Cox-regression, we tested for sex differences in MACE occurrence. Additionally, we compared mortality with an age- and sex-matched control group from the general Dutch population. Results: During a median follow-up of 2.1 years (interquartile range 1.6-2.8), MACEs occurred in 265 men and 103 women (20.7% vs 21.3%, P = .744). Women with myocardial infarction (MI) had significantly more MACE during follow-up than men (hazard ratio [HR] 1.66 for female sex, 95% confidence interval [CI] 1.10-2.50, P = .015), which was also the case for women who had multivessel disease (HR 1.41, 95% CI 1.03-1.94, P = .031). During follow-up, mortality in women presenting with MI was higher than mortality of women in the general population; men with MI did not show this disadvantage. Conclusion: MACEs occurred more often in women than in men who presented with MI or who had angiographic multivessel disease upon coronary angiography. Clinical trial registration: Clinicaltrials.gov identifier: NCT02304744. URL: https://clinicaltrials.gov/ct2/show/NCT02304744.