Women Undergoing Coronary Angiography for Myocardial Infarction or Who Present With Multivessel Disease Have a Poorer Prognosis Than Men.
Coronary artery disease affects both men and women. In this study, we examine sex-specific differences in occurrence of major adverse cardiovascular events (MACEs) after coronary angiography.



We analyzed data from the coronary angiography cohort Utrecht Coronary Biobank (n = 1283 men, 480 women). Using Kaplan-Meier and multivariable Cox-regression, we tested for sex differences in MACE occurrence. Additionally, we compared mortality with an age- and sex-matched control group from the general Dutch population.



During a median follow-up of 2.1 years (interquartile range 1.6-2.8), MACEs occurred in 265 men and 103 women (20.7% vs 21.3%, P = .744). Women with myocardial infarction (MI) had significantly more MACE during follow-up than men (hazard ratio [HR] 1.66 for female sex, 95% confidence interval [CI] 1.10-2.50, P = .015), which was also the case for women who had multivessel disease (HR 1.41, 95% CI 1.03-1.94, P = .031). During follow-up, mortality in women presenting with MI was higher than mortality of women in the general population; men with MI did not show this disadvantage.



MACEs occurred more often in women than in men who presented with MI or who had angiographic multivessel disease upon coronary angiography.



Clinicaltrials.gov identifier: NCT02304744. URL: https://clinicaltrials.gov/ct2/show/NCT02304744.
Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands ICIN-Netherlands Heart Institute, Utrecht, the Netherlands.
Crystel M
CM
Gijsberts
Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands.
Bernadet T
BT
Santema
Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, the Netherlands Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom.
Folkert W
FW
Asselbergs
Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands ICIN-Netherlands Heart Institute, Utrecht, the Netherlands Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Cardiovascular Research Institute, National University Heart Centre, National University Health System, Singapore.
Dominique P V
DP
de Kleijn
Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands.
Michiel
M
Voskuil
Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands.
Pierfrancesco
P
Agostoni
Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands.
Maarten J
MJ
Cramer
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Ilonca
I
Vaartjes
Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands.
Imo E
IE
Hoefer
Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands.
Gerard
G
Pasterkamp
Laboratory of Experimental Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, the Netherlands c.m.gijsberts@umcutrecht.nl.
Hester M
HM
den Ruijter
D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D000072658:Non-ST Elevated Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D012737:Sex Factors; D013997:Time Factors
coronary angiography; epidemiology; major adverse cardiovascular events; sex differences