Differences in management and outcomes between male and female patients with atherothrombotic disease: results from the REACH Registry in Europe.

Jonathan Morrell, Uwe Zeymer, Iris Baumgartner, Tobias Limbourg, Joachim Röther, Deepak L Bhatt, Ph Gabriel Steg
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引用次数: 36

Abstract

Background: Although guidelines recommend similar evaluation and treatment for both sexes, differences in approach and outcomes have been reported.

Design: Prospective, observational registry.

Methods: Consecutive patients at high cardiovascular risk were assessed for risk factors and management at baseline,and followed-up for 2 years.

Results: Twenty-two thousand and twenty-eight patients with documented arterial disease (symptomatic) or three or more atherothrombotic risk factors (asymptomatic) completed the 2-year follow-up of the REduction of Atherothrombosis for Continued Health Registry in Europe (women, 31.5%; men, 68.4%). Women patients were 3.3 years (mean) older than men. Few differences were observed between asymptomatic men and women in risk factor profile or management at baseline. Higher proportions of symptomatic women than men had diabetes (P<0.001), hypertension (P<0.0001), elevated total cholesterol levels (P<0.0001) or elevated triglycerides (P<0.01). A much lower proportion of women than men were current smokers (asymptomatic, 14.6 vs. 29.3%; symptomatic, 11.9 vs.19.5%, both P<0.0001). Within the symptomatic population, women received antithrombotic agents (91.8 vs. 94.9%,P<0.0001) and lipid-lowering agents (68.2 vs. 73.1%, P<0.0001) less frequently than men. After multivariate adjustment,fewer symptomatic women than men had undergone coronary revascularizations at 2 years (odds ratio, 0.72; 95% confidence interval, 0.61-0.85). There were no differences in primary outcomes, including cardiovascular death/myocardial infarction/stroke (odds ratio, 1.01, 95% confidence interval, 0.93-1.11, P=0.78), between the sexes.

Discussion: Although no differences were found in cardiovascular event rates at 2-year follow-up, secondary prevention could be improved in women, which might further reduce event rates.

男性和女性动脉粥样硬化性血栓性疾病患者的治疗和结局差异:来自欧洲REACH注册的结果
背景:尽管指南建议对两性进行类似的评估和治疗,但在方法和结果上存在差异。设计:前瞻性、观察性登记。方法:对连续的心血管高危患者在基线时进行危险因素评估和处理,随访2年。结果:22,28例动脉疾病(有症状)或三个或更多动脉粥样硬化血栓危险因素(无症状)的患者完成了欧洲持续健康登记减少动脉粥样硬化血栓形成的2年随访(女性,31.5%;人,68.4%)。女性患者的平均年龄比男性大3.3岁。无症状男性和女性在危险因素概况或基线管理方面几乎没有差异。有症状的女性患糖尿病的比例高于男性(p讨论:尽管在2年随访中没有发现心血管事件发生率的差异,但女性的二级预防可以得到改善,这可能进一步降低事件发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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