[Acute coronary syndrome in women. Gender differences].

Autor: Olivencia Peña L; Servicio de Medicina Intensiva, Hospital Universitario San Cecilio, Granada, Spain. l.olivencia@hotmail.com, Bueno Cavanillas A, Soto Blanco JM, Yuste Ossorio ME, Barranco Ruiz F
Jazyk: Spanish; Castilian
Zdroj: Medicina clinica [Med Clin (Barc)] 2011 Nov 26; Vol. 137 (14), pp. 623-30. Date of Electronic Publication: 2011 Sep 21.
DOI: 10.1016/j.medcli.2011.03.039
Abstrakt: Background and Objective: Our aims was to investigate possible gender differences in the diagnostic assessment, treatment and prognosis of patients admitted with acute coronary syndrome (ACS).
Patients and Methods: Prospective study of a cohort of 396 patients consecutively admitted to the coronary unit in the period of 18 months with the diagnoses of ACS. We divided the sample into two groups based on gender: 294 men and 102 women. We analysed the diagnostic assessment, hospital treatment, coronary revascularization (ICP), appearance of heart failure (HF) and in-hospital and 1-year mortality. We analyzed predictors of mortality in a multivariate model.
Results: Women were older (70.9±11.9 versus 64.4±12.0; P<.001) and had more comorbidities such as hypertension (70.5% versus 53.7%; P=.003), diabetes (51.0% versus 33.3%; P<.01) and HF (20.5% versus 9.1%; P<.01) than men, while men had greater frequency of smoking (54.42% versus 13.73%; P<.001). Women had higher incidence of cardiogenic shock on admission. There were no differences in thrombolysis and women did not have a different pattern of access to coronary angiography, but men had greater frequency of ICP (50.8% versus 34.6%; P<.01). Women were more likely to develop a higher in-hospital HF (32.6% versus 25.9%; P<.05) and in-hospital mortality (17.6% versus 4.7%; P<.001). In the multivariate analyses, HF on admission OR 8.98 (3.29-24.47), older age OR 1.07 (1.01-1.13) and female gender OR 3.14 (1.27-7.74), were independent predictors of in-hospital mortality.
Conclusions: In our study, female gender was an independent predictor of in-hospital mortality in patients with ACS.
(Copyright © 2010 Elsevier España, S.L. All rights reserved.)
Databáze: MEDLINE