María Plaza-Martín1, Marcelo Sanmartin-Fernandez1, Belén Álvarez-Álvarez2,3, Ruth Andrea4, Tania Seoane-García5, Jessika González-D'Gregorio3,6, Iván Hernández-Betancor7, José Rozado8, Francisco Carrasco-Ávalos9, María Del Mar Alameda-Ortiz10, Sandra Gómez-Talavera3,11,12, Juan Sanchís3,6, Manuel Anguita Sánchez9, Vicente Peral-Disdier10, Borja Ibáñez3,11,12, Susana Del Prado Díaz1, José L Zamorano Gómez1,13,14. 1. Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid. 2. Servicio de Cardiología, Santiago de Compostela. 3. CIBER de enfermedades CardioVasculares (CIBERCV), Madrid. 4. Instituto Cardiovascular, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona. 5. Servicio de Cardiología, Hospital Universitario Virgen Macarena, Sevilla. 6. Servicio de Cardiología, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Valencia. 7. Departamento de Cardiología, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna. 8. Área del Corazón, Hospital Universitario Central de Asturias, Oviedo. 9. Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba. 10. Servicio de Cardiología, Hospital Universitario Son Espases, Palma de Mallorca. 11. IIS-Fundación Jiménez Díaz Hospital. 12. Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC). 13. Universidad de Alcalá, Hospital Universitario Ramón y Cajal. 14. Universidad Francisco de Vitoria, Hospital Universitario La Zarzuela, Madrid, Spain.
Abstract
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.
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.
Authors: Tania Seoane; Beatriz Bullon; Patricia Fernandez-Riejos; Juan Carlos Garcia-Rubira; Nestor Garcia-Gonzalez; Pablo Villar-Calle; Jose Luis Quiles; Maurizio Battino; Pedro Bullon Journal: J Clin Med Date: 2022-05-06 Impact factor: 4.964
Authors: Roos E M van Oosterhout; Annemarijn R de Boer; Angela H E M Maas; Frans H Rutten; Michiel L Bots; Sanne A E Peters Journal: J Am Heart Assoc Date: 2020-05-04 Impact factor: 5.501