학술논문
Abstract 15630: Gender-related Differences in the Management of Chronic Coronary Syndrome: Registry Data of a Tertiary Center in Brazil
Document Type
Academic Journal
Author
Source
Circulation. Nov 17, 2020 142(Suppl_3 Suppl 3):A15630-A15630
Subject
Language
English
ISSN
0009-7322
Abstract
Introduction: There is scarce data on sex-related differences in chronic coronary syndrome (CCS) management in low-and-middle-income countries. We aimed to describe those in CCS patients in a tertiary center in Brazil.Hypothesis: Multiple gender-related differences may affect management of CCS and, subsequently, influence outcome in developing countries - improvement in tertiary care is justified.Methods: Patients from an outpatient clinic with known history of myocardial infarction (MI), coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), or stable angina with documented coronary artery lesions > 50% were evaluated for differences regarding prescription, laboratory data, symptoms and other clinical variables. Patients were deemed to have optimal goal-directed therapy if blood pressure (BP) was < 140/90 mmHg, LDL-cholesterol < 70 mg/dL and were in use of antithrombotics. We also assessed incidence of MI, stroke or death.Results: 625 patients, 208 (33.3%) women and 417 men, were included. We found no sex-related differences in mean age (65 years, SD 9.6 for the cohort) or in prevalence of previous MI, CABG or PCI. Women had higher systolic BP (134 vs 128 mmHg, p < 0.001), higher left ventricular ejection fraction (56 vs 51%, p < 0.001), lower creatinine clearance (69 vs 73 mL/min, p= 0.04), and higher LDL (103 vs 87 mg/dL, p < 0.001). We found no differences regarding glucose levels, BMI or symptoms. Women were less likely to be prescribed calcium-channel blockers (p = 0.04), but equally likely to be prescribed statins. Gender-related differences in LDL and BP were present even after adjustments. Women were less likely to have optimized goal-directed therapy (14.9% vs 28.3%, p < 0.001), even after adjustments. Gender was not associated with event-free survival on one-year follow-up (97% vs 98%).Conclusions: In this setting, women had higher LDL-cholesterol, higher SBP, and lower proportion of optimized goal-directed therapy than men, but gender was not related to worse one-year prognosis.