Sex differences in modifiable risk factors and severity of coronary artery disease
Manfrini, Olivia (University of Bologna)
Yoon, Jinsung (University of California Los Angeles)
van der Schaar, Mihaela (Cambridge Centre for Artificial Intelligence in Medicine)
Kedev, Sasko (University "Ss. Cyril and Methodius")
Vavlukis, Marija (University "Ss. Cyril and Methodius")
Stankovic, Goran (University of Belgrade)
Scarpone, Marialuisa (University of Bologna)
Miličić, Davor (University of Zagreb)
Vasiljevic, Zorana (University of Belgrade)
Badimon, Lina (Institut d'Investigació Biomèdica Sant Pau)
Cenko, Edina (University of Bologna)
Bugiardini, Raffaele (University of Bologna)
Universitat Autònoma de Barcelona

Fecha:	2020
Resumen:	It is still unknown whether traditional risk factors may have a sex-specific impact on coronary artery disease (CAD) burden. 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; Clini​calTr​ials. 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 abso-lute 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. 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.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Conventional risk factors ; Diabetes mellitus ; Obstructive coronary artery disease ; Sex differences ; Smoking
Publicado en:	Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol. 9 Núm. 19 (june 2020) , p. e017235, ISSN 2047-9980

DOI: 10.1161/JAHA.120.017235
PMID: 32981423

29 p, 690.2 KB

El registro aparece en las colecciones:
Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Recerca Sant Pau
Artículos > Artículos de investigación
Artículos > Artículos publicados