Excess Cardiovascular Risk in Women Relative to Men Referred for Coronary Angiography Is Associated With Severely Impaired Coronary Flow Reserve, Not Obstructive Disease
Main finding · CVD eventsResult — go to the resultAdjusted hazard ratio 2.05 95% CI 1.05–4.02Authors' conclusion
Women referred for coronary angiography had a significantly lower burden of obstructive CAD in comparison with men but were not protected from CVD events. Excess cardiovascular risk in women was independently associated with impaired CFR, representing a hidden biological risk, and a phenotype less amenable to revascularization.
Study context
- Population
- Patients referred for invasive coronary angiography after stress PET myocardial perfusion, LVEF >40%43% women
- Participants
- 329 patients
- Exposure
- Women vs men
- Outcome
- MACE:
- CV death
- Hospitalization for nonfatal MI
- HF
- Follow-up
- Median 3.0 years
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
CVD events
Adjusted hazard ratio
2.05
95% CI 1.05–4.02
P = 0.03
As reported in the abstract
Observational data: associations, not effects.
Further findings
Angiographic coronary artery disease (CAD) in low coronary flow reserve (CFR) (<1.6) subgroup
- Women: higher frequency of nonobstructive CAD; men: higher frequency of severely obstructive CAD (n=163)
- P = 0.002
Cardiovascular disease (CVD) events, by sex and CFR (subgroup)
- Only women with severely impaired CFR had significantly increased adjusted risk
- P < 0.0001
- P for interaction=0.04
Baseline: pretest clinical scores, prior MI, angiographic CAD burden
- Lower in women than men
- P < 0.001
Original publication
Summarised from the published abstract; every number is checked against it