Women with coronary artery disease (CAD) may have different long-term outcomes than men, yet markers linked to cardiac death remain less clearly defined. In an analysis published in the European Heart Journal Open, data from the ARTEMIS cohort included 1,946 patients with angiographically confirmed CAD, including 619 women. 

The primary endpoint was cardiac death during 10 years of follow-up. During follow-up, 47 women (7.6%) experienced cardiac death. Multivariable analysis showed several factors independently associated with cardiac death.

Age was associated with a higher risk (hazard ratio [HR] 1.1 per year; 95% confidence interval [CI] 1.0–1.2; P<0.001). Post-revascularization SYNTAX Score was also associated with cardiac death (HR 1.05 per unit; 95% CI 1.0–1.1; P=0.005), as was systolic blood pressure (HR 1.1 per 10-unit increase; 95% CI 1.0–1.3; P=0.039).

Higher high-sensitivity troponin T (HR 1.5 per 10-unit increase; 95% CI 1.1-1.9; P=0.006), hemoglobin A1c (HR 1.4 per unit increase; 95% CI 1.1-1.9; P=0.016), and permanent atrial fibrillation (HR 4.9; 95% CI 1.6-15.0; P=0.005) were also associated with cardiac death.

These findings suggest that combined clinical, angiographic, and biomarker measures may help refine long-term risk assessment in women with CAD.