Risk of ischemic heart diseases adverse outcomes in the working age men and women taking part in the prospective epidemiological surveillance

The course of most cardiovascular diseases in males and females has specific features. Objective. To study the gender-specific features of the modified classification of ischemic heart diseases (IHDs) when assessing the risk of an adverse cardiovascular outcome. Materials and methods. A survey to detect angina pectoris (AP) and myocardial infarction (MI) and a unified electrocardiogram analysis using the Minnesota code were conducted on 13.745 participants in the ESSAY-RF study (40.7% males) aged 25-64 from representative samples of the population of nine regions of the Russian Federation. Over 9.5 years of prospective follow-up, a composite endpoint (CEP; cardiovascular death and/or non-fatal MI or stroke) was identified in 611 (4.4%) subjects, of which 364 (6.5%) were males and 247 (3.0%) were females. Prognostic value was determined by Kaplan—Meier methods and proportional Cox risk-adjusted in sex groups for age and region, in the population for age, region, and sex (model 1), and additionally for smoking and cardiometabolic parameters (continuous and discrete, models 2 and 3). Results. The hazard ratio (HR) of CEP in the new IHDs classification was higher than in the old one. In the definite IHD group, the HR was 3.57 versus 2.6 in males and 3.58 versus 1.98 in females (model 1). In models 2 and 3 (2/3), relative to model 1, the HR was lower at 3.19/3.16 compared to 3.57 in males and 2.52/2.69 compared to 3.58 in females. According to studies, it is impossible to differentiate the survival of individuals in any of the groups according to the criteria of the old classification of IHD. The new classification showed a significantly lower survival rate in men (especially with definite IHD nosology) than in women. Conclusion. The modified classification of ischemic heart diseases is adequate to assess the HR of the composite endpoint in males and females. Compared to women, men of working age have a higher HR of the composite endpoint and poorer survival.