Abstract 1991: Adverse Cardiovascular Outcomes in Women with No Obstructive Coronary Artery Disease: A Report From The NHLBI-sponsored WISE Study And The St James WTH Project
BACKGROUND: Women with clinical findings suggesting ischemia but no obstructive coronary artery disease (CAD) at angiography represent a frequent clinical problem and predicting their prognosis is challenging.
METHODS: The Women’s Ischemia Syndrome Evaluation (WISE) is a study of symptomatic women referred for clinically indicated coronary angiography and followed for a mean 4.7 years. The St. James Women Take Heart (WTH) study is a study of asymptomatic, community-based women with no history of heart disease followed for 10 years. We compared cardiovascular (CV) outcomes (MI, stroke or CHF) or death in 611 women with suspected ischemia but no angiographic evidence of obstructive CAD enrolled in the WISE to those from a cohort of 934 women from the WTH study.
RESULTS: Compared to WISE women (56 ± 11 yrs), WTH women were younger (54 ± 10 yrs, p = 0.001) and had a lower prevalence of obesity, family history of CAD, hypertension and diabetes (p < 0.001 after adjusting for age and race). Five-year annualized event rates were significantly higher in WISE women for all outcomes (figure⇓). These differences remained significant after adjusting for baseline differences in age, race and CAD risk factors.
CONCLUSION: Women with symptoms and/or signs suggesting ischemia but no obstructive CAD may be at elevated risk for adverse CV outcomes compared to asymptomatic community-based women.