Kreimer Fabienne, Schlettert Clara, Abumayyaleh Mohammad, Akin Ibrahim, Hijazi Mido Max, Gotzmann Michael, Hamdani Nazha, Mügge Andreas, Aweimer Assem, El-Battrawy Ibrahim
Department of Cardiology and Rhythmology, University Hospital St. Josef Hospital Bochum, Ruhr University Bochum, Bochum, Germany.
Department of Cardiology II - Rhythmology, University Hospital Muenster, Muenster, Germany.
Sci Rep. 2025 Jul 22;15(1):26573. doi: 10.1038/s41598-025-10932-z.
The aim of this study was to investigate the prognostic impact of sex on in- and out-of-hospital adverse events in troponin-positive patients with non-obstructive coronary artery disease (CAD). 24,775 patients who underwent coronary angiography from 2010 to 2021 were screened for this study. The final study population consisted of 373 troponin-positive patients with non-obstructive CAD with a follow-up period of 6.2 ± 3.1 years, with 185 males and 188 females. The primary study end point was a composite of in-hospital adverse events. Secondary endpoints covered out-of-hospital adverse events during follow-up. In-hospital adverse event rates revealed no significant sex differences (37.8% in males vs. 33.0% in females). Significantly more long-term adverse events occurred in women compared with men during follow-up (27.3% vs. 41.9%). All-cause mortality was significantly higher in women than in men (29.7% vs. 21.2%, p = 0.022). Cox analysis identified age ≥ 70 years, arterial hypertension, diabetes mellitus, supraventricular tachycardia, pulmonary disease, neurological disease, and kidney disease as predictors of out-of-hospital adverse events, whereas male sex was associated with a better long-term outcome. While sex differences were not significant in in-hospital adverse events, females demonstrated a higher incidence of out-of-hospital adverse events and increased mortality during long-term follow-up compared to males.
本研究旨在调查性别对肌钙蛋白阳性的非阻塞性冠状动脉疾病（CAD）患者院内和院外不良事件的预后影响。对2010年至2021年接受冠状动脉造影的24775例患者进行了本研究筛查。最终研究人群包括373例肌钙蛋白阳性的非阻塞性CAD患者，随访期为6.2±3.1年，其中男性185例，女性188例。主要研究终点是院内不良事件的复合终点。次要终点包括随访期间的院外不良事件。院内不良事件发生率显示无显著性别差异（男性为37.8%，女性为33.0%）。随访期间，女性发生的长期不良事件明显多于男性（27.3%对41.9%）。女性的全因死亡率显著高于男性（29.7%对21.2%，p=0.022）。Cox分析确定年龄≥70岁、动脉高血压、糖尿病、室上性心动过速、肺病、神经病和肾病是院外不良事件的预测因素，而男性性别与更好的长期预后相关。虽然性别差异在院内不良事件中不显著，但与男性相比，女性在长期随访期间院外不良事件的发生率更高，死亡率也更高。
