Crystel M Gijsberts1, Aisha Gohar2, Guilielmus H J M Ellenbroek2, Imo E Hoefer2, Dominique P V de Kleijn3, Folkert W Asselbergs4, Hendrik M Nathoe5, Pierfrancesco Agostoni5, Saskia Z H Rittersma5, Gerard Pasterkamp2, Yolande Appelman6, Hester M den Ruijter7. 1. Laboratory of Experimental Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, The Netherlands; ICIN-Netherlands Heart Institute, Utrecht, The Netherlands. 2. Laboratory of Experimental Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, The Netherlands. 3. Laboratory of Experimental Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, The Netherlands; ICIN-Netherlands Heart Institute, Utrecht, The Netherlands; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Cardiovascular Research Institute, National University Heart Centre, National University Health System, Singapore. 4. Department of Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, The Netherlands; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands; Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom. 5. Department of Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, The Netherlands. 6. Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. 7. Laboratory of Experimental Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, The Netherlands. Electronic address: H.M.denRuijter-2@umcutrecht.nl.
Abstract
BACKGROUND: Coronary artery disease (CAD) affects both men and women. Cardiovascular biomarkers have been suggested to relate to CAD severity, but data on sex-specificity is scarce. Therefore, we investigated the association of established biomarkers with the severity of CAD in stable patients undergoing coronary angiography in a sex-specific manner. METHODS: We studied stable patients undergoing coronary angiography and measured CAD severity by SYNTAX score and biomarker levels (N-terminal pro-brain natriuretic peptide (NT pro-BNP), high-sensitivity CRP (hsCRP), cystatin C (CysC), myeloperoxidase (MPO), high-sensitivity troponin I (hsTnI) and von Willebrand factor (VWF)). We tested for sex differences in SYNergy between percutaneous coronary intervention with TAXUS™ and cardiac surgery (SYNTAX) scores and biomarker levels using multivariable ANCOVA. We investigated the association of biomarker levels with SYNTAX score in a multivariable linear regression with interaction terms for sex. RESULTS: We analysed data on 460 men and 175 women. SYNTAX scores were significantly lower in women (9.99 points vs. 11.88 points). Univariably, hsCRP and hsTnI levels were significantly associated with SYNTAX scores (both β 2.5). In multivariable analysis only hsCRP associated with SYNTAX score (β 1.9, p = 0.009). Sex did not modify the association of biomarkers with SYNTAX score. CONCLUSION: CAD severity as quantified by SYNTAX score is lower in women than men based on coronary angiography. The association of biomarkers with CAD severity did not differ between the sexes.
BACKGROUND:Coronary artery disease (CAD) affects both men and women. Cardiovascular biomarkers have been suggested to relate to CAD severity, but data on sex-specificity is scarce. Therefore, we investigated the association of established biomarkers with the severity of CAD in stable patients undergoing coronary angiography in a sex-specific manner. METHODS: We studied stable patients undergoing coronary angiography and measured CAD severity by SYNTAX score and biomarker levels (N-terminal pro-brain natriuretic peptide (NT pro-BNP), high-sensitivity CRP (hsCRP), cystatin C (CysC), myeloperoxidase (MPO), high-sensitivity troponin I (hsTnI) and von Willebrand factor (VWF)). We tested for sex differences in SYNergy between percutaneous coronary intervention with TAXUS™ and cardiac surgery (SYNTAX) scores and biomarker levels using multivariable ANCOVA. We investigated the association of biomarker levels with SYNTAX score in a multivariable linear regression with interaction terms for sex. RESULTS: We analysed data on 460 men and 175 women. SYNTAX scores were significantly lower in women (9.99 points vs. 11.88 points). Univariably, hsCRP and hsTnI levels were significantly associated with SYNTAX scores (both β 2.5). In multivariable analysis only hsCRP associated with SYNTAX score (β 1.9, p = 0.009). Sex did not modify the association of biomarkers with SYNTAX score. CONCLUSION: CAD severity as quantified by SYNTAX score is lower in women than men based on coronary angiography. The association of biomarkers with CAD severity did not differ between the sexes.
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