Recent results from CLARIFY, presented by Professor Gabriel Steg at the European Society of Cardiology Congress 2012 in Munich, reveal that gender has no impact on one-year mortality despite the fact that the risk profiles of women and men with stable coronary artery disease (CAD) differ substantially.

CLARIFY (ProspeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) is the largest international registry in stable CAD outpatients. CLARIFY is ongoing in 45 countries in Europe, the Americas, Africa, the Middle East, and the Asia/Pacific region.

One-year outcomes were analyzed in 30 977 outpatients with stable CAD (23 975 [77.4%] men; 7002 [22.6%] women). On average women were 3 years older than men, had a higher resting heart rate, higher systolic blood pressure, were more likely to have hypertension and diabetes, and were less likely to exercise or smoke. Angina symptoms were also more frequent in women.

Women received less optimized treatment for stable CAD (fewer lipid-lowering agents and aspirin). Also, women were less likely to have undergone diagnostic noninvasive testing or coronary angiography.

After adjustment for age, baseline differences and risk factors, one-year outcomes were similar for men and women for the composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke, for all-cause death, for fatal or nonfatal myocardial infarction, and for cardiovascular death or nonfatal myocardial infarction (Table). Fewer women underwent revascularization, although appropriateness was not analyzed.



Further research is needed to elucidate gender determinants of outcome and to devise strategies to minimize bias in management and treatment of women.