{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:05:27Z","timestamp":1791497127480,"version":"4.3.4"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,3,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline\u2010directed medical therapy, and outcomes among patients with chronic coronary disease with ischemia on stress testing, with and without invasive management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial randomized patients with moderate or severe ischemia to invasive management with angiography, revascularization, and guideline\u2010directed medical therapy, or initial conservative management with guideline\u2010directed medical therapy alone. We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest) and other end points, by sex, in 1168 (22.6%) women and 4011 (77.4%) men. Invasive group catheterization rates were similar, with less revascularization among women (73.4% of invasive\u2010assigned women revascularized versus 81.2% of invasive\u2010assigned men;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Women had less coronary artery disease: multivessel in 60.0% of invasive\u2010assigned women and 74.8% of invasive\u2010assigned men, and no \u226550% stenosis in 12.3% versus 4.5% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). In the conservative group, 4\u2010year catheterization rates were 26.3% of women versus 25.6% of men (\n                      <jats:italic>P<\/jats:italic>\n                      =0.72). Guideline\u2010directed medical therapy use was lower among women with fewer risk factor goals attained. There were no sex differences in the primary outcome (adjusted hazard ratio [HR] for women versus men, 0.93 [95% CI, 0.77\u20131.13];\n                      <jats:italic>P<\/jats:italic>\n                      =0.47) or the major secondary outcome of cardiovascular death\/myocardial infarction (adjusted HR, 0.93 [95% CI, 0.76\u20131.14];\n                      <jats:italic>P<\/jats:italic>\n                      =0.49), with no significant sex\u2010by\u2010treatment\u2010group interactions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Women had less extensive coronary artery disease and, therefore, lower revascularization rates in the invasive group. Despite lower risk factor goal attainment, women with chronic coronary disease experienced similar risk\u2010adjusted outcomes to men in the ISCHEMIA trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/wwwclinicaltrials.gov\">http:\/\/wwwclinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT01471522.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.029850","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T05:01:53Z","timestamp":1709010113000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0284-0655","authenticated-orcid":false,"given":"Harmony R.","family":"Reynolds","sequence":"first","affiliation":[{"name":"NYU Grossman School of Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek D.","family":"Cyr","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9933-5155","authenticated-orcid":false,"given":"C. 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