Gender Differences in the Clinical Characteristics and Outcomes of Patients With Vasospastic Angina - A Report From the Japanese Coronary Spasm Association
Gender Differences in the Clinical Characteristics and Outcomes of Patients With Vasospastic Angina - A Report From the Japanese Coronary Spasm Association
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DOI：
10.1253/circj.cj-12-1486
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发表时间：
2013-05-01
影响因子：
3.3
通讯作者：
Shimokawa, Hiroaki
中科院分区：
文献类型：
--
作者：
Kawana, Akiko;Takahashi, Jun;Shimokawa, Hiroaki
背景：越来越多的证据表明，缺血性心脏病患者的临床特征和预后存在性别差异。然而，血管痉挛性心绞痛（VSA）是否也是如此仍有待阐明。方法和结果：我们在日本冠状动脉痉挛协会的全国多中心登记中共纳入1429例VSA患者（男/女，1090/339，中位年龄66岁）。与男性患者相比，女性患者的特点是年龄较大（中位69岁vs. 66岁），吸烟发生率较低（20% vs. 72%），器质性狭窄不明显（9% vs. 16%）（均P=0.001）。多因素分析表明，主要心脏不良事件（MACE）的预测因子在性别上存在显著差异；女性与年龄和电异常有关，而男性与结构异常有关。总体5年无mace生存率在两性之间具有可比性。然而，当患者按年龄分为3组[年轻(
Background: Accumulating evidence has demonstrated the gender differences in the clinical characteristics and outcomes of patients with ischemic heart disease. However, it remains to be elucidated whether it is also the case for vasospastic angina (VSA).Methods and Results: We enrolled a total of 1,429 VSA patients (male/female, 1090/339; median age 66 years) in our nationwide multicenter registry by the Japanese Coronary Spasm Association. As compared with male patients, female patients were characterized by older age (median 69 vs. 66 years), lower incidence of smoking (20% vs. 72%) and less significant organic stenosis (9% vs. 16%) (all P=0.001). Multivariate analysis demonstrated that the predictors of major adverse cardiac events (MACE) were considerably different by genders; women were more associated with age and electrical abnormalities, whereas men with structural abnormalities. Overall 5-year MACE-free survival was comparable between both genders. However, when the patients were divided into 3 groups by age [young (