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13-07-2010 | Cardiology | Article

Severe angina: more strongly linked with severe CAD in women than men


Free abstract

MedWire News: Women with severe angina are more likely to have severe coronary artery disease (CAD) than men with the same condition, a Canadian study suggests.

Catherine Kreatsoulas (McMaster University, Hamilton, Ontario, Canada) and team suggest that their findings should help to dispel the common misconception that "CAD is a man's disease."

They explain that, although women have lower rates of CAD than men, "the annual mortality rate from CAD is greater than that of breast cancer, even among younger groups," and that this reflects the grave impact of CAD among women.

The team recruited 23,771 male (n=14,645) and female (n=9112) patients referred for first diagnostic angiography from 2000 to 2006.

Approximately 95% (n=22,554) of the patients reported angina symptoms, which the team classified according to the Canadian Cardiovascular Society (CCS) class angina scoring system, from 0 (asymptomatic, n=6869) through IV (severe [angina at rest or on any exertion], n=9832).

All patients were assigned to severe, moderate, or low risk CAD groups, based on angiographic disease severity, and grouped according to age: younger (≤60 years, n=9512) and older (>60 years, n=14259).

The findings, reported in the Journal of Internal Medicine, revealed that patients with CCS IV angina symptoms had a 43% increased risk for severe CAD compared with those without CCS IV angina symptoms. Further analysis revealed that the risk for severe CAD was greater in women with CCS IV angina than men with CCS IV angina, with a 1.82 and 1.28-fold increased risk, respectively (p<0.01), compared with those without CCS IV angina.

The researchers conclude: "Our finding that severe angina is significantly more likely to predict severe CAD in women than men is very important for clinical practice."

They add: "We hope that this information will make it easier for doctors to identify women at risk of severe CAD and target diagnostic and treatment strategies accordingly."

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Lauretta Ihonor

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