OBJECTIVE

To identify gender differences using a new clinical probability model for chronic coronary syndrome (CCS) based on risk factor-weighted clinical likelihood (RF-CL) and traditional Diamond-Forrester CAD pre-test probability model (PTP DF model).

MATERIAL AND METHODS

The registry study included 144 men (mean age 64.7±10.2 years) and 93 women (mean age 67.3±9.4 years) who were examined for suspected CCS. Diagnosis of CAD was carried out in accordance with current (2024) Russian guidelines «Stable coronary artery disease» [6]. Additionally, we calculated clinical probability of obstructive CAD using the RF-CL model.

RESULTS

Clinical likelihood of CCS based on new RF-CL model was higher in men (17% vs. 7%; p<0.001). Men were more often assigned to the group with moderate likelihood of CCS according to RF-CL than women (64% vs. 13%; p<0.001). However, women prevailed in group with low and very low likelihood (p<0.001). Comparative analysis of clinical manifestations of CCS between men and women revealed no significant differences in prevalence of typical angina (25% vs. 20%, p=0.41), atypical angina (21% vs. 29%, p=0.15), non-cardiac chest pain (33% vs. 25%, p=0.19) and dyspnea (42% vs. 29%, p=0.15). After stress testing, 37 positive results and 74 negative results were obtained in men. In the group with positive results, men were significantly more likely to have moderate probability according to the RF-CL model (86% vs. 53%, p<0.001), while in the group with negative results — low probability (13% vs. 42%, p=0.003). There were no differences between women with positive and negative test results (p>0.05). According to clinical data and stress testing, 45 (31%) men and 7 (7%) women were referred for invasive coronary angiography (ICA). When comparing the probabilities of obstructive CAD based on RF-CL and PTP DF model with ICA data, we obtained no significant differences between new and traditional models (p>0.05).

CONCLUSION

In our cohort of patients, the RF-CL clinical probability model did not demonstrate any advantages over traditional DF model of coronary artery disease in men and women.