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RESEARCH PRODUCT

Contemporary differences between men and women with acute coronary syndromes: CIAM multicenter registry.

Tania Seoane-garcíaMarcelo Sanmartín FernándezIván Hernández-betancorJosé Luis Zamorano GómezJosé Luis Zamorano GómezJosé RozadoRuth AndreaFrancisco Carrasco-ávalosSusana Del Prado DíazJessika González-d'gregorioSandra Gómez-talaveraMaría Plaza-martínBorja IbanezManuel Anguita SánchezBelén ÁLvarez-álvarezMaría Del Mar Alameda-ortizJuan SanchisVicente Peral-disdier

subject

MaleAcute coronary syndromemedicine.medical_specialtymedicine.medical_treatmentMyocardial Infarction030204 cardiovascular system & hematologyRevascularizationRisk AssessmentAngina03 medical and health sciences0302 clinical medicineSex FactorsRisk FactorsInternal medicinePalpitationsPrevalenceMedicineHumans030212 general & internal medicineAngina UnstableProspective StudiesRegistriesAcute Coronary SyndromeHealthcare DisparitiesProspective cohort studyAgedAged 80 and overbusiness.industryUnstable anginaAge FactorsGeneral MedicineHealth Status DisparitiesMiddle Agedmedicine.diseaseTreatment OutcomeSpainFemalemedicine.symptomCardiology and Cardiovascular MedicinebusinessDyslipidemiaKidney disease

description

AIM Differences exist in the diagnosis and treatment of acute coronary syndrome (ACS) between men and women. However, recent advancements in the management of ACSs might have attenuated this sex gap. We evaluated the status of ACS management in a multicenter registry in 10 tertiary Spanish hospitals. METHODS We enrolled 1056 patients in our study, including only those with type 1 myocardial infarctions or unstable angina presumably not related to a secondary cause in an 'all-comers' design. RESULTS The women enrolled (29%) were older than men (71.0 ± 12.8 vs. 64.0 ± 12.3, P = 0.001), with a higher prevalence of hypertension (71.0 vs. 56.5%, P < 0.001), insulin-treated diabetes (13.7 vs. 7.9%, P = 0.003), dyslipidemia (62.2 vs. 55.3%, P = 0.038), and chronic kidney disease (16.9 vs. 9.1%, P = 0.001). Women presented more frequently with back or arm pain radiation (57.3 vs. 49.7%, P = 0.025), palpitations (5.9 vs. 2.0%, P = 0.001), or dyspnea (33.0 vs. 19.4%, P = 0.001). ACS without significant coronary stenosis was more prevalent in women (16.8 vs. 8.1%, P = 0.001). There were no differences in percutaneous revascularization rates, but drug-eluting stents were less frequently employed in women (75.4 vs. 67.8%, P = 0.024); women were less often referred to a cardiac rehabilitation program (19.9 vs. 33.9%, P = 0.001). There were no significant differences in in-hospital complications such as thrombosis or bleeding. CONCLUSION ACS presenting with atypical symptoms and without significant coronary artery stenosis is more frequent in women. Selection of either an invasive procedure or conservative management is not influenced by sex. Cardiac rehabilitation referral on discharge is underused, especially in women.

10.2459/jcm.0000000000000812https://pubmed.ncbi.nlm.nih.gov/31260420