Gender differences in the clinical characteristics and outcomes of patients with vasospastic angina--a report from the Japanese Coronary Spasm Association.
BACKGROUND
Accumulating evidence has demonstrated the gender differences in the clinical characteristics and outcomes of patients with ischemic heart disease. However, it remains to be elucidated whether it is also the case for vasospastic angina (VSA).


RESULTS
We enrolled a total of 1,429 VSA patients (male/female, 1090/339; median age 66 years) in our nationwide multicenter registry by the Japanese Coronary Spasm Association. As compared with male patients, female patients were characterized by older age (median 69 vs. 66 years), lower incidence of smoking (20% vs. 72%) and less significant organic stenosis (9% vs. 16%) (all P=0.001). Multivariate analysis demonstrated that the predictors of major adverse cardiac events (MACE) were considerably different by genders; women were more associated with age and electrical abnormalities, whereas men with structural abnormalities. Overall 5-year MACE-free survival was comparable between both genders. However, when the patients were divided into 3 groups by age [young (<50 years), middle-aged (50-64 years) and elderly (≥65 years)], the survival was significantly lower in the young female group (young 82%, middle-aged 92%, elderly 96%, P<0.01), where a significant interaction was noted between age and smoking. In contrast, the survival was comparable among the 3 age groups of male patients.


CONCLUSIONS
These results indicate that there are gender differences in the characteristics and outcomes of VSA patients, suggesting the importance of gender-specific management of the disorder.
Tohoku University Graduate School of Medicine, Sendai, Japan.
Akiko
A
Kawana
Jun
J
Takahashi
Yusuke
Y
Takagi
Satoshi
S
Yasuda
Yasuhiko
Y
Sakata
Ryusuke
R
Tsunoda
Yasuhiro
Y
Ogata
Atsushi
A
Seki
Tetsuya
T
Sumiyoshi
Motoyuki
M
Matsui
Toshikazu
T
Goto
Yasuhiko
Y
Tanabe
Shozo
S
Sueda
Norifumi
N
Kubo
Shin-ichi
S
Momomura
Hisao
H
Ogawa
Hiroaki
H
Shimokawa
D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000453:epidemiology; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013997:Time Factors