Influência da pós-menopausa na DAC comparado ao sexo masculino através da funcionalidade

Abstract

Background: Coronary artery disease (CAD) has become the leading cause of death in women in the Western world, generally manifesting clinically after menopause. However, in addition to the evaluation of CAD, it is also important to consider functional evaluation as a new paradigm of public health in the face of aging. Objective: To analyze the association between functionality and clinical and angiotomographic variables in men and postmenopausal women in CAD. Methods: Cross-sectional, observational study of 132 patients with suspected and/or established CAD between August 2014 and June 2017 who underwent coronary angiotomography. Functionality was assessed using KATZ, MIF and Barthel indices; and also aerobic condition, through Walk Test (TC6M). Calcium and stenosis score was analyzed, and a questionnaire was applied for clinical characterization. The associations were analyzed through logistic regression. Results: Of the sample, 84 (63.3%) were women with a mean age of 61 ± 8 years, similar to men (61.3 ± 6.7 years). Regarding the clinical characterization, the women predominated in obesity (40.2% vs 19.1%, p = 0.014), systemic arterial hypertension (85.4% vs 67.4%, p = 0.017), dyslipidemia (69, 9% vs 51.1%, p = 0.033) and symptoms (81.9% vs 63.8%, p = 0.021). Regarding the aerobic condition, they had a worse performance on the 6MWT with less distance traveled (339.30 ± 94.45 vs 395.74 ± 119.53 meters, p = 0.003). Analyzing the associations, being female represented 3.7 times more risk (p = 0.014) of physical disability, while having severe stenosis, 8.8 times (p = 0.002). Conclusion: Compared to men, being a postmenopausal female represents a greater functional decline with a 3.7 greater risk for physical disability. In this way, functional capacity represents an important marker of cardiovascular risk.