Coronary disease & ACSRandomised controlled trial
Sex differences in coronary disease health Status outcomes: the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial
- randomized
Authors' conclusion
Women with chronic CAD in ISCHEMIA had worse angina-related health status than men at baseline and 1-year. Differences were not explained by demographic or clinical characteristics, intensity of GDMT, or completeness of revascularization. It is thus important to consider other factors that may mediate these results, including differences in nociception, coronary microvascular dysfunction, and/or vasospasm.
Study context
- Population
- Patients with chronic coronary artery disease (CAD) and moderate or severe ischaemia in the ISCHEMIA trialISCHEMIA participants with complete Seattle Angina Questionnaire (SAQ) data
- Participants
- 4,617 patients
- Comparison
- Women vs men: angina-related health status at baseline and 1-year
Primary result
Baseline SAQ-summary score · baseline
Difference
6.5 points
95% CI 5.2–7.8
Women vs Men
difference 6.5 points (95% CI 5.2–7.8)
As reported in the abstract
Further findings
| Outcome | difference (points) |
|---|---|
| Unadjusted 1-year SAQ-SS, women vs men — Women vs Men · Invasive strategy; lower in women | −3.8 |
| Unadjusted 1-year SAQ-SS, women vs men — Women vs Men · Conservative strategy; lower in women | −5.7 |
Unadjusted 1-year SAQ-SS, women vs men
- Sex-based differences attenuated but not eliminated by adjustment for baseline SAQ-SS
- Adjustment for post-randomization treatment (guideline-directed medical therapy (GDMT) intensity, risk factor goal achievement and, in the invasive strategy, complete revascularization) did not narrow the sex difference
Original publication
Sex differences in coronary disease health Status outcomes: the ISCHEMIA trial. Eur Heart J Qual Care Clin Outcomes. Published 13 April 2026. doi:10.1093/ehjqcco/qcag052
Summarised from the published abstract; every number is checked against it