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

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• 作者：Hitoshi  ; Sato MD^a ; Takatoshi  ; Kasai MD ; PhD^a ; Katsumi  ; Miyauchi MD ; FJCC^a ;   ; ^{ktmmy@med.juntendo.ac.jp} ;   ; ^{ktmmy@juntendo.ac.jp} ; Naozumi  ; Kubota MD ; PhD^a ; Kan  ; Kajimoto MD ; PhD^b ; Tadashi  ; Miyazaki MD^a ; Akihisa  ; Nishino MD^a ; Kenji  ; Yaginuma MD^a ; Hiroshi  ; Tamura MD^a ; Takahiko  ; Kojima MD^a ; Ken  ; Yokoyama MD^a ; Takeshi  ; Kurata MD^a ; Atsushi  ; Amano MD ; FJCC^b ; Hiroyuki  ; Daida MD ; FJCC^a
• 关键词：Coronary artery disease ; Revascularization ; Risk factors ; Gender-related ; Long-term outcomes
• 刊名：Journal of Cardiology
• 出版年：2011
• 出版时间：September 2011
• 年：2011
• 卷：58
• 期：2
• 页码：158-164
• 全文大小：284 K

文摘

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.