my personal edition > angina pectoris/mi > news


  E-Mail this DGDispatch to a colleague

DGDispatch

Women with Left Ventricular Dysfunction and Refractory Angina Respond as Well as Men to Enhanced External Counterpulsation: Presented at HFSA

By Gina Alexis
Special to DG News

BOCA RATON, FL -- September 27, 2002 -- Women with left ventricular ejection fraction less than 35 percent and refractory angina who underwent enhanced external counterpulsation showed significant and equal reduction in angina compared to men.

These findings were reported here September 24^th at the 6^th annual scientific meeting of the Heart Failure Society of America (HFSA).

Patients were selected from the international Enhanced External Counterpulsation Patient Registry maintained by the University of Pittsburgh Graduate School of Public Health.

Of the 962 patients with ejection fraction lower than 35 percent, 188 were women. The mean age for women was 68 years and for men, 67 years. Women were less likely to be Caucasian (90 versus 96, p<0.01). On average, coronary artery disease lasted ten years in women and 14 years in men (p<0.001), and previous revascularisation occurred less frequently in women than in men, 82 percent compared to 89 percent (p<0.01).

Overall, women had more diabetes (55 percent compared to 43 percent, p<0.01) and more hypertension (75 percent compared to 65 percent, p<0.01) than men. Women also had less history of myocardial infarction and less prior coronary artery bypass grafting (CABG), 80 percent compared to 88 percent (p<0.01) and 66 percent compared to 74 percent, respectively.

Other risk factors were similar in both groups. Ninety-two percent (92 percent) of women and 90 percent of men were no longer candidates for further revascularisation; rate of Class III and IV angina or unstable angina was 90 percent compared to 88 percent, respectively; nitroglycerin was used by 76 percent of women compared to 70 percent of men; both groups had 28 percent left ventricular ejection fraction.

More than 70 percent of patients in both groups reported their health status as "very poor" with unsatisfactory lifestyles. Women reported lower quality of life scores than men. Both groups reported low occurrences of major cardiovascular events during treatment.

Researchers from the University of Pittsburgh, led by Dr. Ozlem Soram, explained that even though there are significant differences in the way CAD affects men and women, the two group showed a similar significant reduction in the severity of angina following EECP treatment, 66 percent in women and 69 percent of men. Both groups reported no angina or Class I/II angina. Similarly, 46 percent of women and 50 percent of men discontinued use of nitroglycerin.

Both groups reported an increase in lifestyle satisfaction and quality of life (p<0.01). Interestingly, when asked to self-assess, women tended to have a better improvement in quality of life and lifestyle satisfaction.

E-Mail this DGDispatch to a colleague

To print, use this version