Coronary artery disease in women: From the yentl syndrome to contemporary treatment

Table 1 Remaining lifetime risks for cardiovascular disease and other diseases among men and women free of disease at 40 and 70 years of age remaining life[57]

Diseases	Remaining lifetime risk at the age of 40 yr		Remaining lifetime risk at the age of 70 yr
	Men	Women	Men	Women
Any CVD	2 in 31	1 in 21	2 in 32	1 in 2
CHD	1 in 2	1 in 3	1 in 3	1 in 4
AF	1 in 4	1 in 4	1 in 4	1 in 4
CHF	1 in 5	1 in 5	1 in 5	1 in 5
Stroke	1 in 63	1 in 53	1 in 6	1 in 5
Dementia	…	…	1 in 7	1 in 5
Hip fracture	1 in 20	1 in 6	…	…
Breast cancer	…	1 in 8	…	1 in 15
Prostate cancer	1 in 6	…	1 in 9	…
Lung cancer	1 in 13	1 in 16	1 in 15	1 in 20
Colon cancer	1 in 19	1 in 21	1 in 25	1 in 27
DM	1 in 3	1 in 3	1 in 9	1 in 7
Hypertension	9 in 103	9 in 103	9 in 10	9 in 10
Obesity	1 in 3	1 in 3	…	…

¹Age 45 yr;

²Age 65 yr;

³Age 55 yr. AF: Atrial fibrillation; CHD: Coronary heart disease; CHF: Congestive heart failure; CVD: Cardiovascular disease; DM: Diabetes mellitus; …: Not estimated.

Table 2 Women are considerably underrepresented in clinical trials[9]

Study	Sample MT.PCI	Enrollment n	Mean age (yr)	Male (%)	DM (%)	% Prior MI	1/2/3-Vessel CAD	% No symptoms	% Mean EF	% Follow up, yr
RITA-2	514/504	1992-1996	58 (Median)	82	9	47	60/33/7	20	ND1	7
ACME-1	115/112	1987-1990	60	100	18	31	100/0/0	9	68	2.4-52
ACME-2	50/51	1987-1990	60	100	18	41	0/100/0	18	67	2.4-52
AVERT	164/177	1995-1996	59	84	16	42	56/44/0	16	61	1.5
Dakik et al[58]	22/19	1995-1996	53	59	ND	100	44/41/15	0	46	1
MASS	72/72	1988-1991	56	58	18	0	100/0/0	0	76	5
MASS II	203/205	1995-2000	60	68	30	41	0/42/58	ND	67	1
ALKK	151/149	1994-1997	58	87	16	100	100/0/0	0	ND3	4.7
Sievers et al[59]	44/44	ND	56	ND	0	55	100/0/0	ND	ND	2
Hambrecht et al[60]	51/50	1997-2001	61	100	23	46	58/27/15	0	63	1
Bech et al[61]	91/90	ND	61	64	12	25	66/28/6	0	65	2

¹Ninety-three percent of patients had very good or excellent wall motion score;

²Ninety-seven percent of patients were in New York Heart Association class 1;

³Follow-up was 2.4 years (mean) to follow-up interview, 3 years (mean) to follow-up exercise test, and 5 years (median) for ascertainment of deaths and MI events. MT: Medical treatment; DM: Diabetes mellitus; EF: Ejection fraction; ND: No data available.

Table 3 Women have higher rate of vascular complications after percutaneous coronary interventions[30]

Study	n	Vascular complications
		Women	Men	P-value
Alfonso	981	11/157 (7.0%)	16/824 (2.0%)	< 0.01
Antoniucci	1019	14/234 (6.0)	24/785 (3.0%)	0.01
BOAT	989	6/237 (2.5%)	6/752 (0.8%)	0.05
CAVEAT	512	14/128 (10.8%)	22/384 (5.8%)	0.003
NACI	2855	39/971 (4.0%)	28/1884 (1.5%)	< 0.05
NCN	109708	1955/36204 (5.4%)	1985/73504 (2.7%)	< 0.001
NHLBI	2136	24/555 (4.4%)	36/1581(2.3%)	< 0.05
NHLBI	2524	44/883 (5.0%)	43/1641(2.6%)	< 0.01
STARS	1965	44/570 (7.8%)	39/1395 (2.8%)	< 0.01
Trabatoni	1100	15/165 (9.3%)	33/935 (3.5%)	0.004
Welty	5989	34/2096 (1.6%)	23/3893 (0.6%)	< 0.001
WHC	7372	78/2064 (3.8%)	125/5308 (2.4%)	< 0.001
Combined	137150	2278/44264 (5.1%)	2380/92886 (2.6%)