Abstract 15212: Long-term Outcomes Between Genders Are Similar Despite Gender Disparities in High-intensity Statin Use in a Contemporary Cohort of Patients Diagnosed With Nonobstructive Coronary Artery Disease by Invasive Coronary Angiography

Abstract

Introduction: In current practice, high intensity statins are prescribed for patients diagnosed with CAD. However, studies have shown that women are commonly undertreated with statins. We compared long-term outcomes and medication usage patterns related to gender in a contemporary cohort of patients who underwent invasive coronary angiography (ICA) for index evaluation of suspected CAD for an abnormal stress test, stable or unstable angina, following an NSTEMI, or as part of their evaluation for heart failure. Methods: A cohort of 850 consecutive patients who underwent ICA for suspected CAD was classified as having normal/near-normal coronary arteries (≤20% stenosis, n=264), nonobstructive CAD (21-49% stenosis, n=114), or obstructive CAD (≥50% stenosis, n=472). We prospectively determined outcomes (cardiac death, nonfatal MI, and late revascularization) via Kaplan-Meier analysis in these 3 groups. We also obtained baseline and follow up data on statin use, and compared usage in the 3 groups related to gender by Chi-square analysis. Results: Baseline mean LDL values were 103 in men and 113 in women (p<0.001). At a median follow up of 6.0 years, there was an increase in statin use (51.5% at baseline vs 85.0% at follow up in obstructive CAD group; 54.0% vs 67.3% for nonobstructive CAD group). There were no differences in aspirin, beta-blocker, or overall statin usage by gender across all groups (p>0.05 for all medications). No difference in high intensity statin use (atorvastatin 40/80 mg or rosuvastatin 20/40 mg) was seen between genders in patients with obstructive CAD (61.4% of men vs 62.9% of women, p=0.78). Interestingly, there was a significant difference in usage of high intensity statins between genders in patients with nonobstructive CAD (63.9% of men vs 26.8% of women, p =0.001). Yet, outcomes were similar between genders across all stenosis groups (p>0.05 for all groups). Conclusions: Our study shows that fewer women with nonobstructive CAD are treated with high intensity statins compared to their male cohorts. Despite this disparity in treatment, outcomes remained similar between genders. This discrepancy warrants the need for further study and could represent an area for optimization of medical therapy in female patients with nonobstructive CAD.