Author + information
Backgound: Previous data suggest that women may be managed less aggressively for coronary artery disease (CAD), resulting in higher morbidity and mortality. Limited data exist on sex-based disparities in CAD management after coronary CT angiography (CTA).
Methods: Retrospective analysis was performed on patients without known CAD undergoing CTA and with 1-year follow-up. Men and women were compared for demographics, CTA findings and clinical outcomes. Multivariate analysis adjusted for age, body mass index, family history of coronary artery disease (CAD), hypertension, diabetes, dyslipidemia, smoking, and symptoms.
Results: The study group consisted of 3763 (1776 women, 1987 men). Women were older (mean age 55 vs mean age 51, p = <0.0001) with higher burden of symptoms (typical chest pain, atypical chest pain, dyspnea, noncardiac chest pain, and other, 83.4% vs 70.5%, p = <0.0001) and history of hypertension (45.9% vs 39.8%, p = 0.0002) and family history of premature CAD (40.7% vs 34.9%, p = 0.0004). Among patients with >50% stenosis, there were no differences between men and women in rates of invasive coronary angiography (57.6% vs 53.1%, p = 0.30), percutaneous coronary intervention (24.5% vs 27.2%, p = 0.48) or coronary artery bypass grafting (9.5% vs 6.7%, p = 0.22) at 1-year follow-up. However, in patients with CT stenosis <50%, women had higher rates of percutaneous coronary intervention (2% vs 0.4%, p = 0.06) and MACE (hospitalization, revascularization, death, or myocardial infarction, 13.2% vs 8.7%, p = 0.013). Female sex was not a significant predictor of revascularization or clinical outcomes on multivariate analysis, instead, >50% stenosis was the strongest predictor.
Conclusions: Women with nonobstructive disease undergo percutaneous coronary intervention more frequently and have higher rates of MACE. However, female sex is not a significant predictor of revascularization after CTA.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Non Invasive Imaging: Expanding Clinical Applications
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1161-236
- 2017 American College of Cardiology Foundation