title: Clinical characteristics and outcomes of Japanese women undergoing coronary revascularization therapy.
abstract: BACKGROUND
  Limited data are available for gender-based differences in patients undergoing coronary revascularization. This study aimed to identify gender-based differences in risk factor profiles and outcomes among Japanese patients undergoing coronary revascularization.
  
  
  RESULTS
  The subjects consisted of 2,845 women and 6,843 men who underwent first percutaneous coronary intervention or coronary artery bypass grafting in 2000-2002. The outcome measures were all-cause death, major adverse cardiovascular events (MACE) as the composite of cardiovascular death, myocardial infarction and stroke, and any coronary revascularization. The females were older than the males and more frequently had histories of heart failure, diabetes, hypertension, chronic kidney disease, anemia, and dyslipidemia. Unadjusted survival analysis revealed a significantly lower incidence of any revascularization in women (at 3 years: 28.2% vs. 31.2%, P = 0.0037), although no significant gender-based differences were shown in the incidence of all-cause death (at 3 years: 8.8% vs. 8.5%, P = 0.37) or MACE (at 3 years: 12.0% vs. 11.5%, P = 0.61). Multivariate analysis revealed that female gender was associated with significantly lower risks of any revascularization (relative risk = 0.93, 95% confidence interval [CI] = 0.88-0.99, P = 0.014) and all-cause death (relative risk = 0.86, 95%CI = 0.77-0.96, P = 0.005).
  
  
  CONCLUSIONS
  In Japanese patients undergoing first coronary revascularization, the coronary risk factor burden appeared greater in women than in men. Despite the greater modifiable risk factor accumulation, female gender was associated with a lower incidence of repeated revascularization relative to male gender.
authors.affiliation: Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe 650-0046, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Funakoshi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Furukawa
authors.forename: Natsuhiko
authors.initials: N
authors.lastname: Ehara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Kaji
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamamuro
authors.forename: Makoto
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kitai
authors.forename: Kitae
authors.initials: K
authors.lastname: Kim
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tani
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kobori
authors.forename: Michihiro
authors.initials: M
authors.lastname: Nasu
authors.forename: Yukikatsu
authors.initials: Y
authors.lastname: Okada
authors.forename: Toru
authors.initials: T
authors.lastname: Kita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D044466:Asian People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000208:ethnology / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D017052:Hospital Mortality; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012042:Registries; D012086:Reoperation; D019233:Retreatment; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome