Sex differences in prevalence and outcomes of the different endotypes of chronic coronary syndrome in symptomatic patients undergoing invasive coronary angiography: Insights from the global ILIAS invasive coronary physiology registry.

Autor: Vink CEM; Department of Cardiology, Amsterdam UMC - Location VUmc, Amsterdam, the Netherlands., Woudstra J; Department of Cardiology, Amsterdam UMC - Location VUmc, Amsterdam, the Netherlands., Lee JM; Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Boerhout CKM; Department of Cardiology, Amsterdam UMC - Location AMC, Amsterdam, the Netherlands., Cook CM; The Essex Cardiothoracic Centre, Essex, United Kingdom; Anglia Ruskin University, Essex, United Kingdom., Hoshino M; Gifu Heart Center, Department of Cardiovascular Medicine, Gifu, Japan., Mejia-Renteria H; Hospital Clínico San Carlos, IDISSC and Universidad Complutense de Madrid, Madrid, Spain., Lee SH; Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea., Jung JH; Sejong General Hospital, Sejong Heart Institute, Bucheon, Republic of Korea., Echavarria-Pinto M; Hospital General ISSSTE Querétaro - Facultad de Medicina, Universidad Autónoma de Querétaro, Querétaro, Mexico., Meuwissen M; Department of Cardiology, Amphia Hospital, Breda, the Netherlands., Matsuo H; Sejong General Hospital, Sejong Heart Institute, Bucheon, Republic of Korea., Madera-Cambero M; Tergooi Hospital, Department of Cardiology, Blaricum, the Netherlands., Eftekhari A; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Effat MA; Division of Cardiovascular Health and Diseases, Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA., Murai T; Tsuchiura Kyodo General Hospital, Department of Cardiology, Tsuchiura City, Japan., Marques K; Department of Cardiology, Amsterdam UMC - Location VUmc, Amsterdam, the Netherlands; Department of Cardiology, Amsterdam UMC - Location AMC, Amsterdam, the Netherlands., Beijk MAM; Department of Cardiology, Amsterdam UMC - Location VUmc, Amsterdam, the Netherlands; Department of Cardiology, Amsterdam UMC - Location AMC, Amsterdam, the Netherlands., Doh JH; Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea., Piek JJ; Department of Cardiology, Amsterdam UMC - Location AMC, Amsterdam, the Netherlands., van de Hoef TP; Department of Cardiology, Amsterdam UMC - Location VUmc, Amsterdam, the Netherlands; Department of Cardiology, Amsterdam UMC - Location AMC, Amsterdam, the Netherlands; Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands., Christiansen EH; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Banerjee R; Mechanical and Materials Engineering Department, University of Cincinnati, Cincinnati, OH, USA; Research Services, Veteran Affairs Medical Center, Cincinnati, OH, USA., Nam CW; Department of Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea., Niccoli G; Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Institute of Cardiology, Rome, Italy., Nakayama M; Sejong General Hospital, Sejong Heart Institute, Bucheon, Republic of Korea; Cardiovascular Center, Toda Central General Hospital, Toda, Japan., Tanaka N; Department of Cardiology, Tokyo Medical University, Hachioji Medical Center, Tokyo, Japan., Shin ES; Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea., van Royen N; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands., Chamuleau SAJ; Department of Cardiology, Amsterdam UMC - Location VUmc, Amsterdam, the Netherlands; Department of Cardiology, Amsterdam UMC - Location AMC, Amsterdam, the Netherlands., Knaapen P; Department of Cardiology, Amsterdam UMC - Location VUmc, Amsterdam, the Netherlands; Department of Cardiology, Amsterdam UMC - Location AMC, Amsterdam, the Netherlands., Escaned J; Hospital Clínico San Carlos, IDISSC and Universidad Complutense de Madrid, Madrid, Spain., Kakuta T; Tsuchiura Kyodo General Hospital, Department of Cardiology, Tsuchiura City, Japan., Koo BK; Department of Internal Medicine, Seoul National University Hospital, Cardiovascular Center, Seoul, Republic of Korea., Appelman Y; Department of Cardiology, Amsterdam UMC - Location VUmc, Amsterdam, the Netherlands., de Waard GA; Department of Cardiology, Amsterdam UMC - Location VUmc, Amsterdam, the Netherlands. Electronic address: g.dewaard@amsterdamumc.nl.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2023 Nov; Vol. 384, pp. 117167. Date of Electronic Publication: 2023 Jul 08.
DOI: 10.1016/j.atherosclerosis.2023.06.073
Abstrakt: Background and Aims: The management of chronic coronary syndrome (CCS) is informed by studies predominantly including men. This study investigated the relationship between patients sex and different endotypes of CCS, including sex-specific clinical outcomes.
Methods: In patients with CCS undergoing coronary angiography, invasive Fractional Flow Reserve (FFR) and Coronary Flow Reserve (CFR) were measured. Patients were stratified into groups: 1) obstructive coronary artery disease (oCAD) (FFR≤0.80, no revascularization), 2) undergoing revascularization, 3) non-obstructive coronary artery disease with coronary microvascular dysfunction (CMD) (FFR>0.80, CFR≤2.5), and 4) non-obstructive coronary artery disease without CMD (FFR>0.80 and CFR>2.5).
Results: 1836 patients (2335 vessels) were included, comprising 1359 (74.0%) men and 477 (26.0%) women. oCAD was present in 14.1% and was significantly less prevalent in women than in men (10.3% vs 15.5%, respectively p < 0.01). Revascularization was present in 30.9% and was similarly prevalent in women and men (28.2% vs. 31.9%, respectively p = 0.13). CMD was present in 24.2% and was significantly more prevalent in women than men (28.6% vs 22.6%, respectively p < 0.01). Normal invasive measurements were found in 564 patients (33.0% women vs 30.0% men, p = 0.23). Male sex was associated with an increased risk of target vessel failure compared to women (HR.1.89, 95% CI 1.12-3.18, p = 0.018), regardless of CCS-endotype.
Conclusions: Sex differences exist in the prevalence and outcomes of different endotypes of CCS in symptomatic patients undergoing invasive coronary angiography. In particular, oCAD (and subsequent revascularization) were more prevalent in men. Conversely, CMD was more prevalent in women. Overall, men experienced a worse cardiovascular outcome compared to women, independent of any specific CCS endotype.
(Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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