Institute of Gender in Medicine (GiM), Center for Cardiovascular Research (CCR), Charité-Universitaetsmedizin Berlin, Berlin, Germany.
DZHK (German Centre for Cardiovascular Research), Berlin, Germany.
J Womens Health (Larchmt). 2020 Mar;29(3):338-344. doi: 10.1089/jwh.2019.7730. Epub 2019 Nov 26.
Patients with cardiac complaints but without confirmed diagnosis of coronary heart disease by angiography frequently develop cardiac events in the following years. This follow-up study investigated the frequency of cardiac symptoms and cardiovascular events (CVE) 5 years after initial angiography of patients with nonobstructive coronary artery disease (NobCAD, LIFE Heart study), with the aim to identify gender-specific indicators for CVE. In 2014/2015, 1462 women and men with NobCAD, defined as no or non-relevant obstructive coronary artery disease were identified among 2660 subjects participating in the observational angiographic LIFE Heart study. Questionnaires of 820 responding patients were analyzed. The median observation time was 55 months. Cardiac symptoms were found in 53.6% of all patients, significantly more often in women than in men (59.4% vs. 48.8%; = 0.002). CVE occurred in 46.1% of all participants ( = 378/820). Patients with cardiac symptoms had a 2.94 time higher risk for CVE than those without cardiac symptoms ( < 0.001). Men with no cardiac symptoms had significantly more CVE ( = 0.042) than women. Common risk factors for CVE comprised cardiac symptoms, atrial fibrillation, and age. Sex-specific risk factors comprised body mass index (BMI) ≥25 kg/m for women and anxiety for men. Patients with cardiac symptoms have about three times higher risk for CVE within 5 years than patients without cardiac symptoms. Sex differences exist in patients without symptoms where men were at higher risk for CVE. Atrial fibrillation was the strongest indicator for CVE, whereas anxiety was an indicator only in men and BMI ≥25 kg/m only in women, suggesting sex- and gender-specific phenotypic profiles.
患有心脏不适但未经血管造影确诊为冠心病的患者在随后几年中经常发生心脏事件。这项随访研究调查了非阻塞性冠状动脉疾病（LIFE 心脏研究中的 NobCAD）患者血管造影后 5 年内心脏症状和心血管事件（CVE）的发生频率，目的是确定 CVE 的性别特异性指标。
2014/2015 年，在参与观察性血管造影 LIFE 心脏研究的 2660 名受试者中，确定了 1462 名患有 NobCAD 的女性和男性，定义为无或非相关阻塞性冠状动脉疾病。分析了 820 名有反应患者的问卷。中位观察时间为 55 个月。所有患者中有 53.6%存在心脏症状，女性明显多于男性（59.4%比 48.8%；=0.002）。所有参与者中有 46.1%发生 CVE（=378/820）。有心脏症状的患者发生 CVE 的风险是无心脏症状患者的 2.94 倍（<0.001）。无心脏症状的男性发生 CVE 的风险明显高于女性（=0.042）。CVE 的常见危险因素包括心脏症状、心房颤动和年龄。CVE 的性别特异性危险因素包括女性 BMI≥25kg/m 和男性焦虑。有心脏症状的患者在 5 年内发生 CVE 的风险比无心脏症状的患者高约 3 倍。在无症状患者中存在性别差异，其中男性发生 CVE 的风险更高。心房颤动是 CVE 的最强指标，而焦虑仅在男性中是指标，BMI≥25kg/m 仅在女性中是指标，表明存在性别和性别特异性表型特征。
