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Sex Differences in Modifiable Risk Factors and Severity of Coronary Artery Disease.
Sex Differences in Modifiable Risk Factors and Severity of Coronary Artery Disease.
- Source :
-
Journal of the American Heart Association [J Am Heart Assoc] 2020 Oct 20; Vol. 9 (19), pp. e017235. Date of Electronic Publication: 2020 Sep 28. - Publication Year :
- 2020
-
Abstract
- Background It is still unknown whether traditional risk factors may have a sex-specific impact on coronary artery disease (CAD) burden. Methods and Results We identified 14 793 patients who underwent coronary angiography for acute coronary syndromes in the ISACS-TC (International Survey of Acute Coronary Syndromes in Transitional Countries; ClinicalTrials.gov, NCT01218776) registry from 2010 to 2019. The main outcome measure was the association between traditional risk factors and severity of CAD and its relationship with 30-day mortality. Relative risk (RR) ratios and 95% CIs were calculated from the ratio of the absolute risks of women versus men using inverse probability of weighting. Estimates were compared by test of interaction on the log scale. Severity of CAD was categorized as obstructive (≥50% stenosis) versus nonobstructive CAD. The RR ratio for obstructive CAD in women versus men among people without diabetes mellitus was 0.49 (95% CI, 0.41-0.60) and among those with diabetes mellitus was 0.89 (95% CI, 0.62-1.29), with an interaction by diabetes mellitus status of P =0.002. Exposure to smoking shifted the RR ratios from 0.50 (95% CI, 0.41-0.61) in nonsmokers to 0.75 (95% CI, 0.54-1.03) in current smokers, with an interaction by smoking status of P =0.018. There were no significant sex-related interactions with hypercholesterolemia and hypertension. Women with obstructive CAD had higher 30-day mortality rates than men (RR, 1.75; 95% CI, 1.48-2.07). No sex differences in mortality were observed in patients with nonobstructive CAD. Conclusions Obstructive CAD in women signifies a higher risk for mortality compared with men. Current smoking and diabetes mellitus disproportionally increase the risk of obstructive CAD in women. Achieving the goal of improving cardiovascular health in women still requires intensive efforts toward further implementation of lifestyle and treatment interventions. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01218776.
- Subjects :
- Aged
Coronary Artery Disease mortality
Coronary Stenosis etiology
Coronary Stenosis mortality
Female
Humans
Hypercholesterolemia complications
Hypercholesterolemia epidemiology
Hypertension complications
Hypertension epidemiology
Male
Middle Aged
Risk
Risk Factors
Severity of Illness Index
Sex Factors
Smoking adverse effects
Smoking epidemiology
Coronary Artery Disease etiology
Subjects
Details
- Language :
- English
- ISSN :
- 2047-9980
- Volume :
- 9
- Issue :
- 19
- Database :
- MEDLINE
- Journal :
- Journal of the American Heart Association
- Publication Type :
- Academic Journal
- Accession number :
- 32981423
- Full Text :
- https://doi.org/10.1161/JAHA.120.017235