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Aims The aim of this study is to investigate the long-term relationship between revascularization technique and health status in diabetics with multivessel disease. Methods and results Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry, we captured 1319 diabetics with multivessel disease requiring revascularization for an acute coronary syndrome (January 2009–December 2012) and reported health status using the Seattle Angina Questionnaire (SAQ) at baseline, 1, 3 and 5-years [599 underwent coronary artery bypass grafting (CABG); 720 underwent percutaneous coronary intervention (PCI)]. Adjusted analyses were performed using a propensity score-matching technique. After adjustment (including baseline SAQ domain scores), 1-year mean (95% CI) SAQ scores (range 0–100 with higher scores reflecting improved health status) were significantly greater in selected domains for CABG compared to PCI (exertional capacity: 81.7 [79.5–84.0] vs. 78.8 [76.5–81.0], P = 0.07; angina stability: 83.1 [80.4–85.9] vs. 75.0 [72.3–77.8], P Conclusion Improvements in health status with CABG compared with PCI were not sustained long-term. This temporal sequence should be considered when contemplating a revascularization strategy in diabetics with multivessel disease.

While it has been identified that gender (socially manufactured roles, behaviors, expressions, and identities) plays a central role in men's and women's health, the distinction between gender and sex (biological attributes) has largely been ignored in health science research. The purpose of this study was to look at the unique contributions of sex, age, and the Gender Index (GI) to baseline health status in a cohort of patients with coronary artery disease (CAD).Questions that comprised the GI were included in the follow-up questionnaire sent to patients in the APPROACH registry. To examine the relationship between sex, gender, and health status, a sequential linear regression modeling approach was used.A total of 632 patients completed the GI between July and August 2015. The women were significantly older (68 years vs. 66 years, p = 0.02) and significantly more likely to have hypertension (50.8% vs. 38.8%, p = 0.02) compared to the men. Women reported significantly lower mean Seattle Angina Questionnaire (SAQ) scores compared to men. The inclusion of age into the models did not change the relationship between sex and the SAQ scales. However, the inclusion of the GI attenuated the relationship between sex and the SAQ scale scores.Our results support the concept that sex differences in health status outcomes may be better explained by patient's gender-related characteristics, than biological sex characteristics. More importantly, the GI offers a pragmatic composite score to assess the effects of psychosocial factors that researchers interested in measuring gender could use in studies of subjects with CAD.