Abstract 9477: Gender Differences in Clinical Characteristics and Risk Factors of Patients with Vasospastic Angina -A Report from the Nationwide Multi-Center Registry by the Japanese Coronary Spasm Association
Background: Recently, much attention has been paid to gender differences in cardiovascular medicine. Previous studies showed that vasospastic angina (VSA) is more common in male. However, the gender differences in clinical characteristics and outcomes of VSA patients remain to be fully elucidated. Thus, we addressed this important issue in the nationwide multi-center registry by the Japanese Coronary Spasm Association.
Methods: We enrolled a total of 1,429 VSA patients (male/female, 1090/339; median 66 years) from 47 institutes in Japan between September 2007 and December 2008 with a median follow-up period of 32 months. The primary endpoint was defined as major adverse cardiac events (MACE), including cardiac death, non-fatal myocardial infarction (MI), unstable angina and heart failure.
Results: In comparison with the female patients, the male patients were characterized by younger age (median 66 vs. 69 years, P<0.001), higher incidence of smoking (72 vs. 20%, P<0.001), previous MI (7 vs. 3%, P=0.003), organic coronary stenosis >50% (16 vs. 9%, P=0.001) and ST elevation during spontaneous angina attacks (21 vs. 11%, P<0.001). For the treatment of VSA, Ca channel blocker was used in more than 90% of patients in both genders, whereas antiplatelet was more frequently used in male than in female (50 vs. 38%, P<0.001). Although 5-year MACE-free survival rate was comparable (male 91 vs. female 94%), Cox proportional hazard model demonstrated that the risk factors of MACE were considerably different between genders; male patients were more associated with structural abnormality (e.g., organic stenosis, previous MI), whereas female patients with electrical abnormality (e.g., VT/VF during spontaneous attack) (Table).
Conclusions: These results indicate that there are substantial gender differences in the clinical characteristics and the risk factors of MACE in VSA patients, suggesting the importance of gender-specific management of the disorder.
- © 2011 by American Heart Association, Inc.