Sex differences in management and outcomes of patients with stable symptoms suggestive of coronary artery disease: Insights from the PROMISE trial

Although sex differences exist in the management of acute coronary syndromes, less is known about the management and outcomes of women and men with suspected coronary artery disease being evaluated with noninvasive testing (NIT). We investigated sex-based differences in NIT results and subsequent cl...

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Bibliographic Details
Published in:The American heart journal 2019-02, Vol.208, p.28-36
Main Authors: Pagidipati, Neha J., Coles, Adrian, Hemal, Kshipra, Lee, Kerry L., Dolor, Rowena J., Pellikka, Patricia A., Mark, Daniel B., Patel, Manesh R., Litwin, Sheldon E., Daubert, Melissa A., Shah, Svati H., Hoffmann, Udo, Douglas, Pamela S.
Format: Article
Language:English
Subjects:
Abnormalities
Algorithms
Angina
Angina pectoris
Angiography
Aspirin
Aspirin - therapeutic use
Cardiac Catheterization - statistics & numerical data
Cardiovascular disease
Catheterization
Clinical outcomes
Computed Tomography Angiography
Coronary Angiography - methods
Coronary Angiography - statistics & numerical data
Coronary artery
Coronary artery disease
Coronary Artery Disease - diagnosis
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - epidemiology
Coronary Artery Disease - therapy
Coronary vessels
Diabetes
Exercise Test - methods
Exercise Test - statistics & numerical data
Female
Fibrinolytic Agents - therapeutic use
Gender aspects
Heart diseases
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Intubation
Logistic Models
Male
Management
Men
Middle Aged
Myocardial infarction
Pain
Patients
Randomization
Regression analysis
Regression models
Sex
Sex differences
Sex Factors
Signs and symptoms
Test procedures
Time Factors
Treatment Outcome
Women
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Description
Summary:Although sex differences exist in the management of acute coronary syndromes, less is known about the management and outcomes of women and men with suspected coronary artery disease being evaluated with noninvasive testing (NIT). We investigated sex-based differences in NIT results and subsequent clinical management in 4,720 women and 4,246 men randomized to CT angiography versus stress testing in the PROMISE trial. Logistic regression models assessed relationships between sex and referral for catheterization, revascularization, and aspirin or statin use. Cox regression models assessed the relationship between sex and the composite of all-cause death, myocardial infarction, or unstable angina. Women more often had normal NITs than men (61.0% vs 49.6%, P 
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2018.11.002