TY - JOUR T1 - Sex differences in mortality in stable patients undergoing vasodilator stress cardiovascular magnetic resonance JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2021-001619 VL - 8 IS - 1 SP - e001619 AU - Gema Miñana AU - Julio Núñez AU - Jose V Monmeneu AU - Maria P López-Lereu AU - Jose Gavara AU - Víctor Marcos-Garcés AU - Cesar Ríos-Navarro AU - Nerea Pérez AU - Elena de Dios AU - Agustín Fernández-Cisnal AU - Eduardo Núñez AU - Francisco J Chorro AU - Juan Sanchis AU - Vicente Bodi Y1 - 2021/05/01 UR - http://openheart.bmj.com/content/8/1/e001619.abstract N2 - Objective We assessed the influence of the ischaemic burden (IB) as derived from vasodilator stress cardiovascular magnetic resonance (CMR) on the risk of death and the effect of revascularisation across sex.Methods We evaluated 6237 consecutive patients with known or suspected chronic coronary syndrome (CCS). Extensive ischaemia was defined as >5 segments with perfusion deficit. Multivariate Cox proportional hazard regression models were used.Results A total of 2371 (38.0%) patients were women and 583 (9.3%) underwent CMR-related revascularisation. During a median follow-up of 5.13 years, 687 (11.0%) deaths were reported. We found an adjusted differential effect of CMR-derived IB across sex (p value for interaction=0.039). Women exhibited an adjusted lower risk of death and only equaled men’s risk when extensive ischaemia was present. Likewise, CMR-related revascularisation was shown to be differentially associated with the risk of mortality across sex (p value for interaction=0.025). In patients with non-extensive ischaemia, revascularisation was associated with a higher risk of death, with a greater extent in women. At higher IB, revascularisation was associated with a lower risk in men, with more uncertain results in women.Conclusions CMR-derived IB allows predicting the risk of death and gives insight into the potential effect of revascularisation in men and women with CCS. Compared with men, women with non-extensive ischaemia displayed a lower risk and a similar risk with a higher IB. The impact of CMR-related revascularisation on mortality risk was also significantly different according to IB and sex. Further research will be needed to confirm these hypothesis-generating findings.All data relevant to the study are included in the article or uploaded as supplementary information. ER -