دورية أكاديمية
Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial.
| العنوان: | Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial. |
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| المؤلفون: | Reynolds HR; NYU Grossman School of Medicine New York NY USA., Cyr DD; Duke Clinical Research Institute Durham NC USA., Merz CNB; Cedars-Sinai Smidt Heart Institute Los Angeles CA USA., Shaw LJ; Icahn School of Medicine at Mount Sinai, Cardiovascular Research Foundation New York NY USA., Chaitman BR; St. Louis University School of Medicine St. Louis MO USA., Boden WE; VA New England Healthcare System Bedford MA USA., Alexander KP; Duke Clinical Research Institute Durham NC USA., Rosenberg YD; National Heart, Lung, and Blood Institute Bethesda MD USA., Bangalore S; NYU Grossman School of Medicine New York NY USA., Stone GW; Icahn School of Medicine at Mount Sinai, Cardiovascular Research Foundation New York NY USA., Held C; Dept of Medical Sciences, Cardiology Uppsala University and Uppsala Clinical Research Center Uppsala Sweden., Spertus J; Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (UMKC) Kansas City MO USA., Goetschalckx K; Department of Cardiovascular Diseases, UZ Leuven Leuven Belgium., Bockeria O; National Research Center for Cardiovascular Surgery Moscow Russia., Newman JD; NYU Grossman School of Medicine New York NY USA., Berger JS; NYU Grossman School of Medicine New York NY USA., Elghamaz A; Northwick Park Hospital-Royal Brompton Hospital London United Kingdom., Lopes RD; Duke Clinical Research Institute Durham NC USA., Min JK; Cleerly Inc. New York NY USA., Berman DS; Cedars-Sinai Medical Center Los Angeles CA USA., Picard MH; Massachusetts General Hospital and Harvard Medical School Boston MA USA., Kwong RY; Brigham and Women's Hospital Boston MA USA., Harrington RA; Department of Medicine Stanford University School of Medicine Stanford CA USA., Thomas B; Hospital Cruz Vermelha Portuguesa Lisbon Portugal., O'Brien SM; Duke Clinical Research Institute Durham NC USA., Maron DJ; Department of Medicine Stanford University School of Medicine Stanford CA USA., Hochman JS; NYU Grossman School of Medicine New York NY USA. |
| مؤلفون مشاركون: | ISCHEMIA Research Group * |
| المصدر: | Journal of the American Heart Association [J Am Heart Assoc] 2024 Mar 05; Vol. 13 (5), pp. e029850. Date of Electronic Publication: 2024 Feb 27. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Oxford : Wiley-Blackwell |
| مواضيع طبية MeSH: | Coronary Artery Disease*/therapy , Coronary Artery Disease*/complications , Myocardial Infarction*/therapy , Myocardial Ischemia*/therapy , Myocardial Ischemia*/complications, Female ; Humans ; Male ; Chronic Disease ; Goals ; Sex Characteristics ; Treatment Outcome |
| مستخلص: | Background: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chronic coronary disease with ischemia on stress testing, with and without invasive management. Methods and Results: The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial randomized patients with moderate or severe ischemia to invasive management with angiography, revascularization, and guideline-directed medical therapy, or initial conservative management with guideline-directed medical therapy alone. We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest) and other end points, by sex, in 1168 (22.6%) women and 4011 (77.4%) men. Invasive group catheterization rates were similar, with less revascularization among women (73.4% of invasive-assigned women revascularized versus 81.2% of invasive-assigned men; P <0.001). Women had less coronary artery disease: multivessel in 60.0% of invasive-assigned women and 74.8% of invasive-assigned men, and no ≥50% stenosis in 12.3% versus 4.5% ( P <0.001). In the conservative group, 4-year catheterization rates were 26.3% of women versus 25.6% of men ( P =0.72). Guideline-directed medical therapy use was lower among women with fewer risk factor goals attained. There were no sex differences in the primary outcome (adjusted hazard ratio [HR] for women versus men, 0.93 [95% CI, 0.77-1.13]; P =0.47) or the major secondary outcome of cardiovascular death/myocardial infarction (adjusted HR, 0.93 [95% CI, 0.76-1.14]; P =0.49), with no significant sex-by-treatment-group interactions. Conclusions: Women had less extensive coronary artery disease and, therefore, lower revascularization rates in the invasive group. Despite lower risk factor goal attainment, women with chronic coronary disease experienced similar risk-adjusted outcomes to men in the ISCHEMIA trial. Registration: URL: http://wwwclinicaltrials.gov. Unique identifier: NCT01471522. |
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| معلومات مُعتمدة: | U01 HL105907 United States HL NHLBI NIH HHS; U54 AG065141 United States AG NIA NIH HHS; UL1 TR001445 United States TR NCATS NIH HHS |
| فهرسة مساهمة: | Investigator: K Mavromatis; J Linefsky; T Miller; S Banerjee; HR Reynolds; JD Newman; S Bangalore; RM Donnino; LM Phillips; M Saric; K Abdul-Nour; PH Stone; JJ Jang; G Yee; S Weitz; S Arnold; JH O'Keefe; MD Shapiro; M El-Hajjar; MS Sidhu; SA Fein; MT Torosoff; R Lyubarova; S Mookherjee; K Drzymalski; EO McFalls; SA Garcia; SC Bertog; RA Siddiqui; A Ishani; RA Hansen; MG Khouri; JL Goldberg; R Goldweit; RA Cohen; B Mirrer; V Navarro; DE Winchester; M Kronenberg; P Rogal; C McFarren; JF Heitner; IM Dauber; C Cannan; S Sudarshan; PK Mehta; M McDaniel; S Lerakis; A Quyyumi; NK Wenger; CM Hedgepeth; H Hurlburt; A Rosen; Z Sahul; D Booth; S Leung; A Abdel-Latif; H Reda; K Ziada; S Setty; RS Barua; F Hage; C Caldeira; JE Davies; M Leesar; J Heo; A Iskandrian; F Al Solaiman; S Singh; K Dajani; M El-Hajjar; P Der Mesropian; J Sacco; B McCandless; M Orgera; MS Sidhu; I Arif; H Kerr; JF Trejo Gutierrez; G Fletcher; GE Lane; LM Neeson; PP Parikh; PM Pollak; BP Shapiro; K Landolfo; A Gemignani; D O'Rourke; JL Meadows; JT Call; J Hannan; R Bojar; D Kumar; J Mukai; ET Martin; G Vorobiof; A Moorman; S Kinlay; RJ Hamburger; TP Rocco; DL Bhatt; K Croce; JA Quin; J Anumpa; M Zenati; DP Faxon; G Rayos; A Seedhom; L Sullenberger; G Kumkumian; SP Sedlis; RM Donnino; J Lorin; JE Tamis-Holland; R Kornberg; R Leber; S Saba; MW Lee; DR Small; W Nona; PB Alexander; I Rehman; U Badami; K Marzo; IH Robbins; HA Levite; S Shetty; M Patel; GS Hamroff; RW Little; BD Zimbelman; CY Lui; BR Smith; DP Vezina; LL Khor; JD Abraham; DA Bull; SH McKellar; D Booth; J Kotter; A Abdel-Latif; B Hu; AJ Labovitz; M Berlowitz; P Rogal; C McFarren; F Matar; C Caldeira; DJ Maron; F Rodriguez; I Schnittger; WF Fearon; P Deedwania; K Reddy; J Sweeny; C Spizzieri; CP Hochberg; WD Salerno; R Wyman; A Zarka; AV Shah; T Haldis; JA Kohn; S Girotra; O Almousalli; MS Krishnam; JC Milliken; PM Patel; AH Seto; KT Harley; MA Gibson; BJ Allen; R Coram; S Thomas; RG Schwartz; W Chen; M El Shahawy; J Stafford; WB Abernethy; A Zurick; TM Meyer; RG Morford; B Rutkin; S Bokhari; SI Sokol; J Meisner; I Hamzeh; A Misra; M Wall; VL De Rosen; M Alam; MC Turner; TJ Mulhearn; AP Good; NW Shammas; R Chilton; PK Nguyen; M Jezior; PC Gordon; T Crain; R Stenberg; RP Pedalino; J Wiesel; GJ Juang; M Al-Amoodi; D Wohns; EW Lader; M Mumma; L Dharmarajan; JFX McGarvey; TR Downes; GJ Luckasen; B Cheong; S Potluri; RA Mastouri; JA Breall; GE Revtyak; JW Bazeley; D Li; K Giedd; W Old; F Burt; K Sokhon; D Gopal; US Valeti; J Kobashigawa; SC Govindan; RG Nair; CN Manjunath; N Moorthy; SC Manjunath; S Narayanappa; N Pandit; RK Nath; SK Dwivedi; VS Narain; S Chandra; GS Wander; R Tandon; S Ralhan; N Aslam; A Goyal; B Bhargava; G Karthikeyan; S Ramakrishnan; S Seth; R Yadav; S Singh; A Roy; N Parakh; SK Verma; R Narang; S Mishra; N Naik; G Sharma; SK Choudhary; C Patel; G Gulati; S Sharma; VK Bahl; A Mathew; E Punnoose; MA Gadkari; S Gadage; TU Pillay; S Satheesh; A Mathur; U Kaul; J Christopher; R Menon; N Kumar; A Oomman; R Mao; H Solomon; S Naik; SP Khan; J Christopher; N Kumar; P Grant; R Kachru; VK Ajit Kumar; S Ganapathi; K Jayakumar; H Sivadasanpillai; B Sasidharan; TR Kapilamoorthy; J Christopher; P Polamuri; U Kaul; R Senior; A Elghamaz; S Gurunathan; N Karogiannis; BN Shah; RH Trimlett; MB Rubens; ED Nicol; TK Mittal; R Hampson; RA Gamma; MA de Belder; J Thambyrajah; T Nageh; JR Davies; SJ Lindsay; J Kurian; H Jamil; O Raheem; A Hoye; P Donnelly; B Valecka; A Chauhan; C Barr; K Alfakih; J Byrne; I Webb; P Henriksen; P OKane; R de Silva; DSG Conway; AA Sirker; SP Hoole; FN Witherow; N Johnston; M Harbinson; S Walsh; H Douglas; M Luckie; J Sobolewska; P Jeetley; N Patel; T Kotecha; C Travill; I Karimullah; M Al-Bustami; D Braganza; R Henderson; K Pointon; S Naik; T Mathew; C Berry; D Collison; G Roditi; AJ Moriarty; JD Glover; J Pradhan; G Mikhail; DP Francis; G Gosselin; A Diaz; P Rheault; M Barrero; CÉ Gagné; Y Pépin-Dubois; R Costa; YT Sia; C Lemay; A Gisbert; P Gervais; A Rheault; DC Phaneuf; G Gosselin; P Garg; BJW Chow; RC Hessian; RS Beanlands; RF Davies; KR Bainey; AN Cheema; A Bagai; R Wald; S Goodman; JJ Graham; M Peterson; CM Chow; B Abramson; AN Cheema; MT Vakani; J Cha; AG Howarth; G Wong; A Uxa; P Galiwango; S Kassam; A Mukherjee; AJ Ricci; A Lam; S Mehta; J Udell; P Généreux; A Hameed; L Daba; W Hueb; PC Rezende; EER Silva; AC Hueb; PEP Smanio; AS de Quadros; RAK Kalil; JL da Costa Vieira; G Grossmann; PP de Oliveira; L Bridi; S Savaris; JV Vitola; RJ Cerci; FR Farias; MM Fernandes; JA Marin-Neto; A Schmidt; M de Oliveira Lima Filho; RM Oliveira; JRA Chierice; CA Polanczyk; MV Furtado; LF Smidt; AC Carvalho; G Pucci; F Lyra; ARA Junior; MDA Dracoulakis; RGSD Lima; E Figueiredo; PR Caramori; R Tumelero; F Dall'Orto; CT Mesquita; AS Colafranseschi; AC Oliveira; LA Carvalho; IC Palazzo; AS Sousa; EER da Silva; PGM de Barros; L de Pádua Silva Baptista; MJ Rodrigues; MVC de Resende; JF Saraiva; C Costantini; M Demkow; R Pracon; C Kepka; A Teresinska; K Kryczka; J Henzel; M Solecki; E Kaczmarska; T Mazurek; J Drozdz; B Czarniak; M Frach; K Szymczyk; I Niedzwiecka; S Sobczak; T Ciurus; P Jakubowski; M Misztal-Teodorczyk; D Teodorczyk; A Fratczak; M Szkopiak; P Lebioda; M Wlodarczyk; A Plachcinska; J Kusmierek; M Miller; H Marciniak; K Wojtczak-Soska; K Luczak; T Tarchalski; A Cichocka-Radwan; H Szwed; GA Szulczyk; A Witkowski; K Kukula; M Celinska-Spodar; J Zalewska; G Gajos; K Bury; P Pruszczyk; M Roik; K Loboz-Grudzien; L Sokalski; B Brzezinska; M Lesiak; M Lanocha; KW Reczuch; Z Kalarus; A Swiatkowski; M Szulik; WJ Musial; L Bockeria; K Petrosyan; T Trifonova; AM Chernyavskiy; EI Kretov; IO Grazhdankin; LL Bershtein; SA Sayganov; AM Kuzmina-Krutetskaya; EV Zbyshevskaya; NO Katamadze; EA Demchenko; PS Kozlov; VY Kozulin; EI Lubinskaya; J Lopez-Sendon; A Castro; ER Salicio; G Guzman; G Galeote; S Valbuena; J Peteiro; MD Martínez-Ruíz; R Pérez-Fernández; JJ Cuenca-Castillo; X Flores-Ríos; Ó Prada-Delgado; G Barge-Caballero; JRG Juanatey; MS Bayarri; VP Nuñez; RO Sanchez; BC Alvarez; CP Gil; AM Monzonis; A Sionis; MV Perales; JM Padró; AS Peñaranda; JG Picart; AG Iglesias; XG Marimon; GP Lladó; FC Costa; V Miro; JL Diez; P Calvillo; FM Ortuño; MV Chávarri; AT Montolliu; EP Bermudez; G De La Morena; MG Blancas; JEC Luena; F Fernandez-Aviles; J Chen; Y Wu; Y Ma; Y Yang; Z Ji; X Yang; W Lin; H Zeng; X Fu; B Yang; S Wang; G Cheng; Y Zhao; X Fang; Q Zeng; X Su; Q Li; SP Nie; Q Yu; J Wang; S Zhang; Z Liu; GP Perna; M Marini; G Gabrielli; S Provasoli; E Verna; L Monti; B Nardi; A Di Chiara; A Mortara; M Galvani; F Ottani; M Sicuro; P Calabro; T Formisano; G Tarantini; U Cucchini; AL Andres; E Racca; C Briguori; R Amati; W Vergoni; A Russo; R Fanelli; KK Poh; P Chai; T Lau; JP Loh; EL Tay; K Teoh; LL Teo; CC Ong; RC Wong; PH Loh; T Kofidis; WX Chan; KH Chan; D Foo; JLK Kong; CM Er; FH Jafary; T Chua; R Doerr; J Stumpf; K Matschke; G Simonis; CT Kadalie; U Sechtem; P Ong; PC Schulze; B Goebel; K Lenk; G Nickenig; H Schuchlenz; S Weikl; IM Lang; K Huber; G Jakl-Kotauschek; A Vertes; A Varga; G Fontos; B Merkely; G Kerecsen; S Hinic; M Zdravkovic; V Mudrenovic; B Crnokrak; BD Beleslin; NN Boskovic; MT Petrovic; MR Dobric; ZZ Markovic; AS Mladenovic; N Cemerlic-Adjic; G Davidovic; R Vucic; MN Dekleva; G Stankovic; S Apostolovic; J Escobedo; R Baleón-Espinosa; AS Campos-Santaolalla; E Durán-Cortés; JM Flores-Palacios; A García-Rincón; M Jiménez-Santos; JV Peñafiel; JA Ortega-Ramírez; A Valdespino-Estrada; EA Rosas; JB Selvanayagam; MX Joseph; ST Thambar; JF Beltrame; GS Hillis; C Thuaire; T Dutoiu; PG Steg; JM Juliard; MS Slama; R El Mahmoud; E Nicollet; P Goube; G Barone-Rochette; A Furber; L Bière; A Laucevicius; J Celutkiene; E Kedhi; J Timmer; R Hermanides; E Kaplan; RK Riezebos; P Samadi; E van Dongen; SR Niehe; H Suryapranata; S van Vugt; R Ramos; D Cacela; A Santana; A Fiarresga; L Sousa; H Marques; L Patricio; L Bernanrdes; P Rio; R Carvalho; R Ferreira; T Silva; I Rodrigues; P Modas; G Portugal; J Fragata; FJ Pinto; MN Menezes; GC Lopes; AG Almeida; PC Silva; A Nobre; AR Francisco; N Ferreira; RL Lopes; L Guzman; JC Figal; O Méndiz; C Cortés; RR Favaloro; C Alvarez; J Courtis; G Zeballos; L Schiavi; M Rubio; GP Devlin; R Fisher; RAH Stewart; HD White; J Benatar; S Kedev; IP Mitevska; ES Kostovska; H Pejkov; C Held; K Eggers; G Frostfelt; N Johnston; M Olsowka; A Åkerblom; I Soveri; J Aspberg; T Sharir; D Elian; A Kerner; S Massalha; K Fukuda; S Kohsaka; S Yasuda; S Nishimura; K Goetschalckx; F Van de Werf; K Claes; CL Hung; CH Yun; CJ Hou; JY Kuo; HI Yeh; TC Hung; JY Li; CY Chien; CT Tsai; CC Liu; FC Yu; YH Lin; WR Lan; CH Yen; JP Tsai; KT Sung; M Ntsekhe; S Pandie; CA Viljoen; M De Andrade; T Moccetti; MG Rossi; M Abdelhamid; A Adel; A Kamal; H Mahrous; S El Kaffas; H El Fishawy; C Pop; M Claudia; BA Popescu; C Ginghina; D Deleanu; VA Iliescu; MH Al-Mallah; A Aljzeeri; H Najm; A Alghamdi; WEM Ramos; S Kuanprasert; A Prommintikul; W Nawarawong; S Woragidpoonpol; T Tepsuwan; N Taksaudom; C Rimsukcharoenchai; J Euathrongchit; Y Wannasopha; S Yamwong; P Sritara; S Aramcharoen; K Meemuk; A Khairuddin; HA Hadi; SA Yahaya Keywords: coronary artery disease; ischemic heart disease; sex differences; women's health |
| سلسلة جزيئية: | ClinicalTrials.gov NCT01471522 |
| تواريخ الأحداث: | Date Created: 20240227 Date Completed: 20240311 Latest Revision: 20240502 |
| رمز التحديث: | 20240502 |
| مُعرف محوري في PubMed: | PMC10944079 |
| DOI: | 10.1161/JAHA.122.029850 |
| PMID: | 38410945 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2047-9980 |
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| DOI: | 10.1161/JAHA.122.029850 |