title: Sex differences in presentation and outcome among patients with type 2 diabetes and coronary artery disease treated with contemporary medical therapy with or without prompt revascularization: a report from the BARI 2D Trial (Bypass Angioplasty Revascularization Investigation 2 Diabetes).
abstract: OBJECTIVE
  This study evaluated differences in outcome among women and men enrolled in the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial.
  
  
  BACKGROUND
  Women and men with coronary artery disease have different clinical presentations and outcomes that might be due to differences in management.
  
  
  METHODS
  We compared baseline variables, study interventions, and outcomes between women and men enrolled in the BARI 2D trial and randomized to aggressive medical therapy alone or aggressive medical therapy with prompt revascularization.
  
  
  RESULTS
  At enrollment, women were more likely than men to have angina (67% vs. 58%, p < 0.01) despite less disease on angiography (Myocardial Jeopardy Index 41 ± 24 vs. 46 ± 24, p < 0.01; number of significant lesions 2.3 ± 1.7 vs. 2.8 ± 1.8, p < 0.01). Over 5 years, no sex differences were observed in BARI 2D study outcomes after adjustment for difference in baseline variables (death/myocardial infarction/cerebrovascular accident: hazard ratio: 1.11, 99% confidence interval [CI]: 0.85 to 1.44). However, women reported more angina than men (adjusted odds ratio: 1.51, 99% CI: 1.21 to 1.89, p < 0.0001) and had lower scores for the Duke Activity Status Index (adjusted beta coefficient: -1.58, 99% CI: -2.84 to -0.32, p < 0.01).
  
  
  CONCLUSIONS
  There were no sex differences in death, myocardial infarction, or cerebrovascular accident among patients enrolled in the BARI 2D trial. However, compared with men, women had more symptoms and less anatomic disease at baseline, with persistence of higher angina rates and lower DASI scores after 5 years of medical therapy with or without prompt revascularization. (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes [BARI 2D]; NCT00006305).
authors.affiliation: Department of Medicine, Division of Cardiology, St. Luke's and Roosevelt Hospitals and Columbia University, New York, New York, USA. jtamis@chpnet.org
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: Tamis-Holland
authors.forename: Jiang
authors.initials: J
authors.lastname: Lu
authors.forename: Mary
authors.initials: M
authors.lastname: Korytkowski
authors.forename: Michelle
authors.initials: M
authors.lastname: Magee
authors.forename: William J
authors.initials: WJ
authors.lastname: Rogers
authors.forename: Neuza
authors.initials: N
authors.lastname: Lopes
authors.forename: Lisa
authors.initials: L
authors.lastname: Mighton
authors.forename: Alice K
authors.initials: AK
authors.lastname: Jacobs
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology* / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D002121:Calcium Channel Blockers / Q000008:administration & dosage; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D048909:Diabetes Complications / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004032:Diet; D004232:Diuretics / Q000008:administration & dosage; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D015995:Prevalence; D011788:Quality of Life; D040242:Risk Reduction Behavior; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D016540:Smoking Cessation; D012944:Social Support; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D002317:Cardiovascular Agents; D004232:Diuretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors