Abstract 10840: Major Adverse Cardiac Event Rates in a Contemporary Cohort of Women with Ischemia and No Obstructive Coronary Artery Disease: Results from the Women's Ischemia Syndrome Evaluation
Background: The Women’s Ischemia Syndrome Evaluation (WISE) identified elevated adverse outcomes and recurrent angiography rates among women with signs and symptoms of ischemia but no obstructive coronary artery disease (CAD). We explored whether changes in demographic characteristics or medical therapies over time were associated with altered rates of adverse outcomes and recurrent angiography.
Methods: We evaluated risk factors, medication use, adverse outcomes and recurrent angiography rates in a contemporary cohort of 211 women with signs and symptoms of ischemia and no obstructive CAD from the WISE Coronary Vascular Dysfunction (WISE CVD) study, enrolled from 2009-2012 and followed for a mean of 13.1 + 2.0 months, compared to 523 women with a similar presentation enrolled in the original WISE cohort from 1996-1999 followed for a mean of 13.1 + 2.0 months. Adverse outcomes at 1 year were defined as the first occurrence of death (all-cause and cardiovascular), nonfatal myocardial infarction, nonfatal stroke, and hospitalization for angina or congestive heart failure. Recurrent angiography rates were also tabulated.
Results: Comparative characteristics demonstrate significantly lower baseline rates of hypertension, dyslipidemia, and smoking and higher rates of aspirin, statin, nitrate, and ranolazine use at 1 year in WISE CVD (p<0.01) (table). Cumulative comparative Kaplan-Meier estimated 1 year hospitalizations for angina, combined adverse outcomes, and recurrent angiography rates were not different between the two groups (table).
Conclusions: In a contemporary cohort of women with signs and symptoms of ischemia but no obstructive CAD, demographic and medication changes characterized by fewer risk factors and greater medication use were not associated with a change in short-term adverse outcomes and recurrent angiography rates compared to the original WISE cohort. Future research is needed to develop therapeutic strategies in this population.
- © 2012 by American Heart Association, Inc.