Gender Differences in Secondary Prevention After Coronary Revascularization: Analysis of Diabetic Patients with Multivessel Disease

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  • YONEDA YUKI
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine
  • KAJIMOTO KAN
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine
  • MIYAUCHI KATSTUMI
    Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine
  • YAMAMOTO TAIRA
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine
  • INABA HIROTAKA
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine
  • TAMBARA KEIICHI
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine
  • DOHI SHIZUYUKI
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine
  • IWAMURA TAI
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine
  • TSURUTA RYO
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine
  • IZAWA TOMOAKI
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine
  • DAIDA HIROYUKI
    Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine
  • AMANO ATSUSHI
    Department of Cardiovascular Surgery, Cardiology, Juntendo University Faculty of Medicine

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Objective: Analyses based on the results of various clinical studies have shown a gender difference in the significance of lifestyle and risk factors that cause progression of atherosclerosis. However, there have been few investigations of gender differences in secondary prevention of the most severe form of atherosclerosis, which follows coronary revascularization in diabetes patients with multivessel coronary artery disease. Methods: the subjects were 493 diabetic patients (394 males and 99 females) with multivessel disease who underwent coronary artery revascularization at our hospital between 2002 and 2008. Death from all causes, cardiac death, and major adverse cardiac and cerebrovascular events (MACCE) were compared between men and women. Kaplan-Meier survival analysis was performed with univariate analysis of each endpoint. The multivariate Cox proportional hazard model was then used to calculate the hazard ratio. Results: The mean age of the women was 70 years, significantly higher than the 64 years for men. During a mean follow-up period of 2.6 years, no gender differences were seen in all-cause deaths, cardiac deaths, or MACCE on multivariate analysis. Conclusions: This study demonstrated that there were no gender differences related to long-term outcome at any of the end points in secondary prevention of severe coronary artery disease in diabetes patients.

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