Sex differences in health status trajectories among Chinese patients with angina pectoris: insights from the GREAT registry study
Bibliographic record
Abstract
Abstract Background Angina pectoris (AP) significantly impacts health-related quality of life. However, sex-based differences in health status trajectories for patients with AP in real-world Chinese cohorts remain underexplored. Purpose To evaluate sex-based differences in health status trajectories among Chinese patients with AP, with implications for personalised care. Methods This post-hoc analysis utilised data from the GREAT registry, a multicentre, prospective, observational study. Patients were stratified by sex, and health status was assessed using the Seattle Angina Questionnaire (SAQ) at baseline, 3, 6, 9, and 12 months. Changes in the SAQ summary score (SAQ-SS) and its domains were analysed using linear mixed-effects models to identify sex-based differences in health status trajectories. Logistic regression analysis was used to evaluate sex differences in achieving clinically meaningful improvement (defined as a SAQ-SS increase ≥ 10 points) at 12 months across various subgroups. Results A total of 1,556 patients with AP (1,112 men and 444 women) were included. At baseline, women had significantly lower SAQ-SS compared to men (59.52 ± 12.93 vs. 62.64 ± 12.61, P < 0.001), despite a lower prevalence of extensive coronary involvement (≥ 2-vessel disease: 61.7% vs. 73.7%, P = 0.01). Women also had lower revascularisation rates during index hospitalisation (38.3% vs 50.6%, P < 0.001). Long-term medication adherence was similar between sexes (P ≥ 0.05). By 12 months, both sexes achieved comparable SAQ-SS (77.65 ± 7.82 vs. 77.68 ± 7.03, P = 0.94). The linear mixed-effects model revealed that women exhibited greater improvement in health status over time compared to men, with consistent results across most SAQ domains (P for interaction < 0.001), except for the angina frequency domain (P for interaction = 0.08) (Figure 1). Logistic regression identified female sex as an independent predictor of clinically meaningful improvement in SAQ-SS (OR: 1.4, 95% CI: 1.09–1.81, P = 0.01), after adjusting for age, coronary artery involvement, coronary revascularization, and anti-angina medication use. Subgroup analyses showed that women experienced greater clinically meaningful improvements in SAQ-SS across several groups, including those aged < 65 years, with hypertension, without diabetes, with unstable angina, not undergoing coronary revascularisation, and not using nitrates or nicorandil (all P < 0.05) (Figure 2). Conclusion Significant sex differences exist in health status trajectories among Chinese patients with AP, with women showing greater improvements over time in the natural course of treatment. These findings suggest that women may benefit more from proactive treatment strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".