Takeaway
- Women vs men had a lower risk of first subsequent major adverse cardiovascular event (MACE) and recurrent coronary heart disease (CHD), but a higher risk of stroke, heart failure and all-cause mortality, after the first CHD event.
Why this matters
- As more people survive their initial CHD events, a better understanding of the risk of subsequent events is required to ensure more targeted secondary prevention strategies in this patient population.
Study details
- This UK population-based cohort study assessed electronic health records (EHRs) of 143,702 adults (women, 43.9%) with any incident non-fatal CHD using data from primary (UK Clinical Practice Research Datalink) or secondary (Hospital Episode Statistics) care and the national death registry (median follow-up, 13.4 years).
- Primary outcome: first subsequent MACE after incident CHD.
- Funding: None.
Key results
- Overall, 91,706 individuals had a MACE after incident CHD.
- The incidence rate for MACE was higher among men vs women (31.03 vs 19.62 per 100 person-years).
- Women vs men had a lower risk of first subsequent MACE (HR, 0.67; 95% CI, 0.66-0.68) and recurrent CHD (HR, 0.60; 95% CI, 0.59-0.61) after incident CHD.
- Following incident CHD, women vs men had a higher risk of:
- stroke (HR, 1.26; 95% CI, 1.19-1.33);
- heart failure (HR, 1.09; 95% CI, 1.04-1.15); and
- all-cause mortality (HR, 1.05; 95% CI, 1.02-1.07).
Limitations
- Retrospective design.
- CHD subtyping in EHRs is unreliable.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.