Gender disparities in acute coronary syndrome. Issue 5 (May 2015)

• Record Type: Journal Article
• Authors: Ghadri, Jelena R.; Sarcon, Annahita; Jaguszewski, Milosz; Diekmann, Johanna; Bataiosu, Roxana D.; Hellermann, Jens; Csordas, Adam; Baumann, Lukas; Schöni, Aline A.; Lüscher, Thomas F.; Templin, Christian
• Is Part Of: Journal of cardiovascular medicine. Volume 16:Issue 5(2015:May)
• Publication Date: 2015-05
• Subjects: Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000000248
• Languages: English
• ISSNs: 1558-2027

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Aims</title> <p>The aim of the present study was to analyze gender disparities in a large cohort of acute coronary syndrome (ACS) patients from the Zurich Acute Coronary Syndrome (Z-ACS) Registry.</p> </sec> <sec> <title>Methods</title> <p>Gender disparities in ACS were examined. The primary endpoint included in-hospital death rate, and the secondary endpoint major adverse cardiac and cerebrovascular events (MACCEs) at 30-day follow-up. Furthermore, independent predictors for MACCEs and death were identified.</p> </sec> <sec> <title>Results</title> <p>In total, 2612 patients with ACS were identified. Out of these, 23% were women. The mean age was higher in women (68.6 ± 12.2; <italic>P</italic> < 0.001). Troponin-T on admission (1.33 ± 4.64 vs. 1.19 ± 3.04 μg/l; <italic>P</italic> = 0.002) and N-terminal of the prohormone brain natriuretic peptide on admission (3456.2 ± 7286.7 vs. 1665.6 ± 4800.6 ng/l; <italic>P</italic> < 0.001) were higher in women compared with men. Single-vessel disease was more common in women (44.9 vs. 39.7%; <italic>P</italic> = 0.023) and, conversely, multivessel disease was more prevalent in male patients as compared with their female counterparts (59.4 vs. 54.4%; <italic>P</italic> = 0.029). At discharge, men were more likely prescribed statins (89.4 vs. 85.2%; <italic>P</italic> = 0.004). Overall mortality and MACCEs were similar for both genders. In women, peak creatine kinase and peak C-reactive protein emerged as independent predictors for MACCEs and SBP on admission, and maximal C-reactive protein and use of glycoprotein IIb/IIIa inhibitors (GPIIb/IIIa) as strong independent predictors for in-hospital death.</p> </sec> <sec> <title>Conclusion</title> <p>The present results suggest a closing gap in short-term outcome and improvement in cardiac care between women and men. Nonetheless, differences in treatment strategies continue to exist, particularly pertaining to statin regimens at discharge, which might potentially have a powerful impact on long-term outcomes and gender disparities.</p> </sec> </abstract>