Sex and age differences in patients with acute coronary syndrome and non-obstructive coronary arteries: presentation and outcome

Autor:	Giovanni Biglino, Julian Strange, Amardeep Ghosh Dastidar, N Joshi, E Fiori, Sven Plein, Stephen Dorman, Thomas W Johnson, M G L Williams, Chris B Lawton, E De Garate, Kate Liang, L Spagnoli, A Baritussio, C Bucciarelli-Ducci
Rok vydání:	2021
Předmět:	medicine.medical_specialty Acute coronary syndrome Age differences business.industry medicine.disease Coronary arteries medicine.anatomical_structure Internal medicine medicine Cardiology In patient Presentation (obstetrics) Cardiology and Cardiovascular Medicine business
Zdroj:	European Heart Journal. 42
ISSN:	1522-9645 0195-668X
Popis:	Aims A substantial number of patients present with acute coronary syndrome (ACS) and non-obstructive coronary arteries. Sex and age differences in these patients are not well understood. This study aims to evaluate the impact of sex and age on clinical presentation and outcome in patients with ACS and non-obstructive coronary arteries, with either an ischaemic or non-ischaemic cause. Methods and results Consecutive patients with an ACS and non-obstructive coronary arteries (n=719) from a single tertiary centre underwent comprehensive cardiovascular magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE). The primary endpoint was all-cause mortality. CMR was performed at a median time of 30 days after presentation and identified a diagnosis in 74% of patients. Patients with an ischaemic or non-ischaemic aetiology (n=529) on CMR were followed prospectively. All-cause mortality was 11% over a median follow up of 4.9 years, with no significant difference between sexes (11% versus 11% p=0.732). Women were more likely to have an ischaemic aetiology on CMR (40% v 31%, p=0.037). Age group (HR 1.48, p=0.002), log peak troponin (HR 0.78, p=0.033) and LVEF (HR 0.98, p=0.032) were independent predictors of mortality. Men aged >60 years with a non-ischaemic aetiology on their CMR were at higher risk of death than women >60 years (p=0.003). Conclusions There is no difference in all-cause mortality between sexes in patients presenting with ACS and non-obstructive coronary arteries but increasing age is an important predictor of mortality in both sexes. Funding Acknowledgement Type of funding sources: None. Sex differences in CMR diagnosisSex, age and mortality
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::c16a47e445f0a8e8682cc8674635712a https://doi.org/10.1093/eurheartj/ehab724.1488 Zobrazit plný text záznamu