Sex disparities in the presentation, management and outcomes of patients with acute coronary syndrome: insights from the ACS QUIK trial

Autor: Erin D. Michos, Haitham Khraishah, Mazen Albaghdadi, Dhaval Kolte, Mohamad B Kassab, Njambi Mathenge, Abdulhamied Alfaddagh, Barrak Alahmad, Sun Young Jeong
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Acute coronary syndrome
medicine.medical_specialty
India
Disease
030204 cardiovascular system & hematology
acute coronary syndrome
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Sex Factors
Diabetes mellitus
Epidemiology
medicine
Prevalence
Diseases of the circulatory (Cardiovascular) system
cardiac catheterisation
Humans
030212 general & internal medicine
Hospital Mortality
Registries
Stroke
Aged
Retrospective Studies
business.industry
Disease Management
Middle Aged
medicine.disease
Treatment Outcome
RC666-701
Relative risk
Emergency medicine
epidemiology
Female
Presentation (obstetrics)
coronary angiography
Cardiology and Cardiovascular Medicine
business
Health Care Delivery
Economics and Global Health Care
coronary artery disease
Follow-Up Studies
Zdroj: Open Heart
Open Heart, Vol 8, Iss 1 (2021)
ISSN: 2053-3624
Popis: AimsOur aim was to explore sex differences and inequalities in terms of medical management and cardiovascular disease (CVD) outcomes in a low/middle-income country (LMIC), where reports are scarce.MethodsWe examined sex differences in presentation, management and clinical outcomes in 21 374 patients presenting with acute coronary syndrome (ACS) in Kerala, India enrolled in the Acute Coronary Syndrome Quality Improvement in Kerala trial. The main outcomes were the rates of in-hospital and 30-day major adverse cardiovascular events (MACEs) defined as composite of death, reinfarction, stroke and major bleeding. We fitted log Poisson multivariate random effects models to obtain the relative risks comparing women with men, and adjusted for clustering by centre and for age, CVD risk factors and cardiac presentation.ResultsA total of 5191 (24.3%) patients were women. Compared with men, women presenting with ACS were older (65±12 vs 58±12 years; pConclusionWomen presenting with ACS in Kerala, India had greater burden of CVD risk factors, including hypertension and diabetes mellitus, longer delays in presentation, and were less likely to receive guideline-directed management. Women also had worse in-hospital and 30-day outcomes. Further efforts are needed to understand and reduce cardiovascular care disparities between men and women in LMICs.
Databáze: OpenAIRE
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