• Cardiology Clinical Trials
• Coronary Artery Disease

Despite substantial differences in the risk profiles of men and women with stable coronary artery disease (CAD), outcomes at 1 year appear to be similar, according to an analysis of data from the international Prospective Observational Longitudinal Registry of Patients with Stable Coronary Artery Disease [CLARIFY; Steg PG et al. Eur Heart J 2012] registry. The study adds new insights into gender differences in stable CAD, as relatively few studies have compared outcomes in this patient population. However, results should be interpreted in the context of an observational registry data set.

The study included data for 30,977 outpatients with stable CAD, defined as prior myocardial infarction (MI), angiographic coronary disease (>50% lesion), ischemic symptoms and a positive stress test, or prior coronary revascularization from 45 countries; 23,975 (77.4%) of the patients were men. The main outcome was a composite of cardiovascular (CV) death, MI, or stroke. Analyses were time to first event, and comparisons by gender were adjusted for differences in patient baseline characteristics.

At 1 year, the rate of the primary outcome was similar for men and women (adjusted rates, 1.7% vs 1.8%, respectively; OR, 0.93; 95% CI, 0.75 to 1.15; p=0.5), reported Philippe Gabriel Steg, MD, Hôpital Bichat, Paris, France, who presented the findings of the study. Women were at similar risk as men for major CV outcomes (Figure 1). Prof. Steg added that there was an interaction between gender and age, with younger women having slightly better outcomes than younger men; however, the same was not true for middle-aged or older women (p-interaction=0.0077).

The risk profile differed substantially by gender, with women more likely to have hypertension or diabetes (Table 1). Women were also more likely to have angina but were less likely to have had diagnostic non-invasive testing or coronary angiography, to have received evidence-based pharmacologic treatments, or to have had revascularization (Table 1).

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Figure 1.

Major CV Outcomes at 1 Year.

CABG=coronary artery bypass grafting; CV=cardiovascular; MI=myocardial infarction; PCI=percutaneous coronary intervention.Reproduced with permission from the European Society of Cardiology. All rights reserved. Copyright © 2012.

Prof. Steg noted several limitations to the study. The primary limitation was the relatively low number of women, which he noted may have been related to the inclusion criteria required by the study. In addition, the cohort sample may not be representative of a population-based sample, as physician and patient participation in the CLARIFY registry is voluntary. Also, despite adjustments for potential confounders, residual confounding cannot be excluded.

• © 2012 MD Conference Express®