Women with PAD at lower MACE, mortality risks than men

The risks for major adverse cardiovascular events (MACE) and mortality are lower among women with peripheral artery disease (PAD) than men, but the risk for limb events over a mean follow-up of 30 months is comparable between sexes, a study has shown.

A total of 13,885 patients with PAD (28 percent women) were included. PAD severity and medical treatment were similar between sexes, but fewer women reported prior lower extremity revascularization (54.8 percent vs 57.3 percent; p=0.006). Women were also older (mean age, 67.8±8.9 vs 66.1±8.2 years; p<0.001) and more likely to have diabetes mellitus (p=0.004), hypertension, hyperlipidaemia and chronic kidney disease (p<0.001 for all).

Women had a lower risk of MACE (9.5 percent vs 11.2 percent; adjusted hazard ratio [aHR], 0.77, 95 percent confidence interval [CI], 0.68–0.88; p<0.001) and all-cause mortality (7.6 percent vs 9.7 percent; aHR, 0.61, 95 percent CI, 0.53–0.71; p<0.001) than men over a mean follow-up of 30 months. However, no difference was seen between sexes in the risks for major adverse limb events (2.6 percent vs 3.0 percent) and hospitalization for acute limb ischaemia (1.6 percent vs 1.7 percent).

“Understanding sex-specific differences and dissociation between baseline cardiovascular risk and subsequent cardiovascular events requires further investigation,” the authors said.

This posthoc analysis of the EUCLID* trial assessed sex-specific differences in MACE and limb events. Time-to-event outcomes were compared between men and women using Cox proportional hazards models. Covariates were then introduced following adjusted model selection.

“Patients with PAD have a higher risk of MACE compared with those without PAD,” the authors noted.

*Examining Use of Ticagrelor in PAD