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CLINICAL CHARACTERISTICS AND OUTCOMES OF JAPANESE FEMALE PATIENTS UNDERGOING CORONARY REVASCULARIZATION THERAPY
A128.E1202 JACC March 9, 2010 Volume 55, issue 10A
MYOCARDIAL ISCHEMIA AND INFARCTION CLINICAL CHARACTERISTICS AND OUTCOMES OF JAPANESE FEMALE PATIENTS UNDERGOING CORONARY REVASCULARIZATION THERAPY ACC Poster Contributions Georgia World Congress Center, Hall B5 Tuesday, March 16, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Stable Ischemic Syndrome--Revascularization in Special Populations Abstract Category: Stable Ischemic Syndrome Presentation Number: 1270-323 Authors: Shunsuke Funakoshi, Natsuhiko Ehara, Takeshi Kitai, Makoto Kinoshita, Atsushi Kobori, Shuichirou Kaji, Atsushi Yamamuro, Tomoko Tani, Michihiro Nasu, Yukikatsu Okada, Toru Kita, Yutaka Furukawa, Takeshi Morimoto, Takeshi Kimura, Kobe City Medical Center General Hospital, Kobe, HI, Japan, Kyoto University Hospital, Kyoto, Japan Background: There are limited large-scale data on gender differences in risk factor profiles and cardiovascular outcomes for Japanese patients with coronary artery disease. The purpose of this study is to reveal gender-based differences in carrying risk factors and cardiovascular outcomes in Japanese patients undergoing coronary revascularization. Methods: A total of 9877 Japanese patients who underwent first elective PCI or CABG in 2000-2002 have been registered to CREDO-Kyoto multicenter registry. The study subjects consist of 2845 women and 6843 men after excluding patients with malignant disease. The patients were followed up for a median of 3.6 years. Clinical characteristics, treatment patterns and predictors of the major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, MI and stroke, were compared by gender. Results: Female patients were older than male and more frequently had history of heart failure (20.5% vs 15.5%, p<0.0001), diabetes (42.0% vs 37.6%, p<0.0001), hypertension (75.3% vs 66.6%, p<0.0001), chronic kidney disease(CKD) (52.3% vs 35.7%, p<0.0001), anemia (44.3% vs 18.4%, p<0.0001) and hyperlipidemia (59.5% vs 47.0%, p<0.0001). Unadjusted survival analyses demonstrated that there were no significant gender differences in survival free from any cause death or MACE, although the rate of freedom from any revascularization was significantly higher in women (at 3 years,71.6% vs.68.6%, log-rank p=0.0037). Multivariate analysis revealed that CKD, atrial fibrillation, history of stroke, multivessel disease, history of heart failure and diabetes were common significant predictors of MACE in men and women. In addition, Age>75, history of peripheral vascular disease and anemia were included in the independent predictors of MACE in men. Conclusions: Coronary risk factor burden itself appeared greater in female than in male patients. The higher prevalence of modifiable risk factors and the comparable future risk for MACE relative to male patients suggest that the optimal risk factor management is critically important in female patients after coronary revascularization.
MYOCARDIAL ISCHEMIA AND INFARCTION CLINICAL CHARACTERISTICS AND OUTCOMES OF JAPANESE FEMALE PATIENTS UNDERGOING CORONARY REVASCULARIZATION THERAPY ACC Poster Contributions Georgia World Congress Center, Hall B5 Tuesday, March 16, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Stable Ischemic Syndrome--Revascularization in Special Populations Abstract Category: Stable Ischemic Syndrome Presentation Number: 1270-323 Authors: Shunsuke Funakoshi, Natsuhiko Ehara, Takeshi Kitai, Makoto Kinoshita, Atsushi Kobori, Shuichirou Kaji, Atsushi Yamamuro, Tomoko Tani, Michihiro Nasu, Yukikatsu Okada, Toru Kita, Yutaka Furukawa, Takeshi Morimoto, Takeshi Kimura, Kobe City Medical Center General Hospital, Kobe, HI, Japan, Kyoto University Hospital, Kyoto, Japan Background: There are limited large-scale data on gender differences in risk factor profiles and cardiovascular outcomes for Japanese patients with coronary artery disease. The purpose of this study is to reveal gender-based differences in carrying risk factors and cardiovascular outcomes in Japanese patients undergoing coronary revascularization. Methods: A total of 9877 Japanese patients who underwent first elective PCI or CABG in 2000-2002 have been registered to CREDO-Kyoto multicenter registry. The study subjects consist of 2845 women and 6843 men after excluding patients with malignant disease. The patients were followed up for a median of 3.6 years. Clinical characteristics, treatment patterns and predictors of the major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, MI and stroke, were compared by gender. Results: Female patients were older than male and more frequently had history of heart failure (20.5% vs 15.5%, p<0.0001), diabetes (42.0% vs 37.6%, p<0.0001), hypertension (75.3% vs 66.6%, p<0.0001), chronic kidney disease(CKD) (52.3% vs 35.7%, p<0.0001), anemia (44.3% vs 18.4%, p<0.0001) and hyperlipidemia (59.5% vs 47.0%, p<0.0001). Unadjusted survival analyses demonstrated that there were no significant gender differences in survival free from any cause death or MACE, although the rate of freedom from any revascularization was significantly higher in women (at 3 years,71.6% vs.68.6%, log-rank p=0.0037). Multivariate analysis revealed that CKD, atrial fibrillation, history of stroke, multivessel disease, history of heart failure and diabetes were common significant predictors of MACE in men and women. In addition, Age>75, history of peripheral vascular disease and anemia were included in the independent predictors of MACE in men. Conclusions: Coronary risk factor burden itself appeared greater in female than in male patients. The higher prevalence of modifiable risk factors and the comparable future risk for MACE relative to male patients suggest that the optimal risk factor management is critically important in female patients after coronary revascularization.