Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843

This article has now been updated. Please use the final version.

Sex Differences in Cardiovascular Disease-Related Hospitalization and Mortality in Japan ― Analysis of Health Records From a Nationwide Claim-Based Database, the Japanese Registry of All Cardiac and Vascular Disease (JROAD) ―
Satsuki NomaKatsuhito KatoToshiaki OtsukaYoko M. NakaoRie AoyamaAtsuko NakayamaAtsushi MizunoSachiko KankiYuko WadaYoshiko WatanabeChizuko Aoki-KamiyaKatsuyuki HoshinaSaeko TakahashiYasuko BandoTomomi IdeJunko HonyeMariko Harada-ShibaAya SaitoYukiko NakanoYasushi SakataKyoko SoejimaKoji MaemuraYayoi Tetsuou Tsukada the JROAD-DIVERSITY Investigators
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Article ID: CJ-23-0960

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Abstract

Background: The prevalence of cardiovascular disease (CVD) is rising in Japan with its aging population, but there is a lack of epidemiological data on sex differences in CVD, including acute coronary syndrome (ACS), acute heart failure (AHF), and acute aortic disease.

Methods and Results: This retrospective study analyzed data from 1,349,017 patients (January 2012–December 2020) using the Japanese Registry Of All Cardiac and Vascular Diseases database. ACS patients were youngest on average (70.5±12.9 years) and had the lowest female proportion (28.9%). AHF patients had the oldest mean age (79.7±12.0 years) and the highest proportion of females (48.0%). Acute aortic disease had the highest in-hospital mortality (26.1%), followed by AHF (11.5%) and ACS (8.9%). Sex-based mortality differences were notable in acute aortic disease, with higher male mortality in Stanford Type A acute aortic dissection (AAD) with surgery (males: 14.2% vs. females: 10.4%, P<0.001) and similar rates in Type B AAD (males: 6.2% vs. females: 7.9%, P=0.52). Aging was a universal risk factor for in-hospital mortality. Female sex was a risk factor for ACS and acute aortic disease but not for AHF or Types A and B AAD.

Conclusions: Sex-based disparities in the CVD-related hospitalization and mortality within the Japanese national population have been highlighted for the first time, indicating the importance of sex-specific strategies in the management and understanding of these conditions.

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