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Int J Cardiol. 2017 Dec 15;249:6-11. doi: 10.1016/j.ijcard.2017.05.094. Epub 2017 May 26.

Gender differences in long-term clinical outcomes and prognostic factors in patients with vasospastic angina.

Author information

1
Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Cardiovascular Center, Department of Internal Medicine, Bundang Jesaeng Hospital, Daejin Medical Center, Gyeonggi-do, Republic of Korea.
3
Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Republic of Korea.
4
Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: cardiochoi@skku.edu.

Abstract

BACKGROUND:

Men are more likely to suffer from vasospastic angina (VSA) than women; however, gender differences in the long-term prognosis of VSA patients have not been fully elucidated. We sought to investigate clinical outcomes and predictive factors of VSA patients according to gender.

METHODS:

A total of 986 patients (838 men and 148 women) with a positive result on intracoronary ergonovine provocation test between January 2003 and December 2014 were analyzed. The primary outcome was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction, revascularization, or rehospitalization due to recurrent angina.

RESULTS:

Women were younger and showed a lower prevalence of smoking or fixed coronary stenosis than men. The risk for MACE was similar between male and female patients (hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.65-1.39; p=0.79). In multivariable prediction models for MACE, high-sensitivity C-reactive protein (hs-CRP) level was a significant predictor of MACE in male patients (HR, 1.95; 95% CI, 1.25-3.06; p=0.003), but there was no significant predictor in female patients. There was a significant interaction between hs-CRP level and MACE rate across genders (interaction p=0.02).

CONCLUSIONS:

Long-term clinical outcome was not different between genders. Hs-CRP was an important predictor of long-term clinical outcomes in male patients with VSA, but not in female patients.

KEYWORDS:

Gender difference; Prognosis; Vasospastic angina

PMID:
28592384
DOI:
10.1016/j.ijcard.2017.05.094
[Indexed for MEDLINE]

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