Regardless of Ethnicity, Women Have Worse Outcomes From Acute Coronary Syndromes

MedicalResearch.com Interview with:

Karin H Humphries, MBA, DSc | Scientific Director BC Centre for Improved Cardiovascular Health UBC-HSF Professor in Women's Cardiovascular Health Vancouver, BC

Karin Humphries

Karin H Humphries, MBA, DSc | Scientific Director
BC Centre for Improved Cardiovascular Health
UBC-HSF Professor in Women’s Cardiovascular Health
Vancouver, BC

Medical Research: What is the background for this study?

Response: Prior studies have shown that among patients with obstructive coronary artery disease (CAD), women have higher short- and long-term mortality rates as compared to men. Furthermore, a few studies have highlighted the existence of ethnic differences in the incidence of acute myocardial infarction (AMI) and outcomes following an AMI event. However, the joint contribution of sex and ethnicity on outcomes of patients with obstructive  coronary artery disease remains unknown.

Our primary objective was to extend these findings by examining the joint impact of sex and ethnicity on long-term adverse outcomes of all patients with angiographic evidence of obstructive CAD presenting with myocardial ischemia.

Our study included a population-based cohort of patients ≥ 20 years of age who underwent coronary angiography for acute coronary syndromes (ACS) or stable angina in British Columbia, Canada with angiographic evidence of ≥ 50% stenosis in any epicardial artery.

Medical Research: What are the main findings?

Response: Women have poorer outcomes following coronary angiography, compared to men, irrespective of ethnicity and their clinical presentation (ACS or stable angina). The observed sex differences persisted even after adjustment for differences in the baseline demographic and clinical characteristics. A key finding of our research is that the most common adverse outcome, regardless of sex or initial clinical presentation, is hospital readmission for angina. This was observed for all sex-ethnic groups except for Chinese women, whose adverse outcomes were driven by higher mortality rates.

Medical Research: What should clinicians and patients take away from your report?

Response: Our message to clinicians and patients is that heart disease in women remains a concern and that more targeted cardiac care and research for women across different ethnicities are needed. Efforts to reduce hospital readmission for angina should be a high priority as it places a significant burden on the health care system and reduces patients’ quality of life.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Studies to examine the predictors of ongoing chest pain post angiography should focus on both sex and ethnic differences, in order to reduce the burden of hospital readmissions for angina. In addition, research to explicate why Chinese women are more likely to die post CAD diagnosis than other patients is urgently needed.

Citation:

Sex and Ethnic Differences in Outcomes of ACS and Stable Angina Patients With Obstructive Coronary Artery Disease

Mona Izadnegahdar, Martha Mackay, May K. Lee, Tara L. Sedlak, Min Gao, C. Noel Bairey Merz, and Karin H. Humphries

Circ Cardiovasc Qual Outcomes. 2016;9:S26S35,doi:10.1161/CIRCOUTCOMES.115.002483

Karin H Humphries (2016). Regardless of Ethnicity, Women Have Worse Outcomes From Acute Coronary Syndromes 

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