Long-term outcomes of women with coronary artery disease following complete coronary revascularization

• Published in: Journal of cardiology 2011-09, Vol.58 (2), p.158-164
• Main Authors: Sato, Hitoshi, MD, Kasai, Takatoshi, MD, PhD, Miyauchi, Katsumi, MD, FJCC, Kubota, Naozumi, MD, PhD, Kajimoto, Kan, MD, PhD, Miyazaki, Tadashi, MD, Nishino, Akihisa, MD, Yaginuma, Kenji, MD, Tamura, Hiroshi, MD, Kojima, Takahiko, MD, Yokoyama, Ken, MD, Kurata, Takeshi, MD, Amano, Atsushi, MD, FJCC, Daida, Hiroyuki, MD, FJCC
• Format: Article
• Language: English
• Subjects: Aged; Asian Continental Ancestry Group; Cardiovascular; Cause of Death; Coronary artery disease; Coronary Artery Disease - mortality; Coronary Artery Disease - surgery; Female; Follow-Up Studies; Gender-related; Humans; Incidence; Japan - epidemiology; Long-term outcomes; Male; Middle Aged; Multivariate Analysis; Myocardial Revascularization - mortality; Revascularization; Risk Factors; Sex Factors; Stroke - epidemiology; Survival Rate; Time Factors; Treatment Outcome
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2011.03.003

Summary Background Although coronary artery disease (CAD) is less prevalent in women than in men, early mortality rate is higher in women with CAD than in men with CAD following coronary revascularization. In terms of the long-term outcomes after coronary revascularization, limited data are available. Especially, in the Japanese CAD population, no data about sex-related differences in long-term outcomes after coronary revascularization exist. The aim of this study was to compare long-term outcomes between men and women following complete revascularization in Japanese patients with CAD. Methods We collected data from 1836 consecutive patients who underwent complete revascularization by percutaneous coronary interventions and/or bypass surgeries. All-cause and cardiac mortality and the incidence of stroke were compared between men and women. In addition to the univariate analysis, a multivariate Cox regression was carried out in order to adjust for differences in baseline characteristics. Results There were 274 female patients (14.9%). They were older, had greater total cholesterol levels, and were more likely to have multivessel disease than men. During follow-up [mean (SD), 11.4 (2.9) years], 412 patients died (including 131 patients who died of cardiac causes), and 130 had a stroke. In the multivariate analysis, female patients did not have a significant risk for all-cause mortality (hazard ratio [HR], 1.01; p = 0.993), cardiac mortality (HR, 1.41; p = 0.256), or stroke (HR, 0.71; p = 0.309). Conclusions In the present study involving CAD patients who underwent complete revascularization, we showed that, although women were older and had more unfavorable risk profiles, they did not have a greater risk of long-term all-cause mortality, cardiac mortality, or stroke incidence, compared to men.