Women and men with stable coronary artery disease have similar clinical outcomes: insights from the international prospective CLARIFY registry

Abstract

AimsMen and women differ in terms of presentation and management in coronary artery disease (CAD). Whether these differences translate into different clinical outcomes in stable CAD is unclear. We analysed data from the international prospective CLARIFY registry to compare cardiovascular clinical outcomes in men and women with stable CAD.Methods and resultsWe analysed 1-year outcomes in 30 977 outpatients with stable CAD [23 975 (77.4%) men; 7002 (22.6%) women]. Women were older than men, more likely to have hypertension and diabetes, and less likely to exercise or smoke. They had more frequent angina, but were less likely to have undergone diagnostic non-invasive testing or coronary angiography. Women received less optimized treatment for stable CAD. One-year outcomes were similar for men and women for the composite of cardiovascular death, non-fatal myocardial infarction, or stroke [adjusted rates 1.7 vs. 1.8%, respectively, odds ratio (OR) 0.93, 95% confidence interval (CI) 0.75–1.15]; all-cause death (adjusted 1.5 vs. 1.6%, OR: 0.91, 95% CI: 0.72–1.13); fatal or non-fatal myocardial infarction (adjusted 1.0 vs. 0.9%, OR: 0.81, 95 CI: 0.60–1.08); and cardiovascular death or non-fatal myocardial infarction (adjusted 1.4 vs. 1.4%, OR: 0.89, 95% CI: 0.70–1.12). Fewer women underwent revascularization (2.6 vs. 2.2%, OR: 0.77, 95% CI: 0.64–0.93), although appropriateness was not analysed.ConclusionThe risk profiles of women and men with stable CAD differ substantially. However, 1-year outcomes were similar. Fewer women underwent revascularization. Further research is needed to better understand gender determinants of outcome and devise strategies to minimize bias in the management and treatment of women.

Darapladib for Preventing Ischemic Events in Stable Coronary Heart Disease

“…These standards of care are consistently higher than those that were observed in patients with stable chronic coronary heart disease who were included in previous large international registries. [16][17][18] These factors probably reduced event rates in the two study groups and may have reduced the proportion of events that were modifiable.…”

Hemoglobin and Change in Hemoglobin Status Predict Mortality, Cardiovascular Events, and Bleeding in Stable Coronary Artery Disease

“…[11][12][13][14] The study was established to characterize outpatients with stable coronary artery disease in terms of clinical profiles, therapeutic strategies, and outcomes. Patients are followed up with annual visits for 5 years, with interim telephone calls every 6 months to maximize participant retention.…”

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

“…В этих исследованиях оценки ежегодной смертности варьируют от 1,2% до 2,4% [23][24][25][26][27][28], при этом ежегод-ная частота смерти от заболевания сердца составляет от 0,6% до 1,4%, а частота развития нефатального инфаркта миокарда (ИМ) составляет от 0,6% (в иссле-довании RITA-2 (Second Randomized Intervention Treatment of Angina)) [26] до 2,7% (в исследовании COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation)) [23]. Эти оценки согласуются с данными из наблюдатель-ных регистров [13,29].…”