Do differences related to gender impact coronary angiogram findings and outcomes in patients presenting with non-ST elevation myocardial infarction?

    Authors

    Keywords

    coronary artery disease, gender differences, major adverse cardiac events

    DOI

    https://doi.org/10.15836/ccar2024.386

    Full Text

    **Introduction**: Data on the prognostic significance of gender among patients with non-ST elevation acute coronary syndrome (NSTE-ACS) are conflicting. Several studies have identified greater mortality rates in women, attributing this trend to the higher incidence of accompanying comorbidities, higher age and suboptimal treatment among female subjects. Conversely, other research contends that even after adjusting for these factors, the prognosis for women remains poorer. Whether these disparities persist in the era of new guidelines and primary or early PCI treatment is yet to be established. (1) The aim of the study was to assess gender disparities in the severity of coronary artery disease (CAD) and major adverse cardiac events’ (MACE) incidence, among patients with NSTE-ACS. **Patients and Methods**: We conducted a registry-based study including patients with NSTE-ACS hospitalized in our centre from January 2017 to January 2023. Data on CAD severity and Syntax score, which evaluates complexity based on coronary anatomy and lesion characteristics, were collected. Follow-up data were acquired through clinical follow up visits or telephone interviews. The MACE was a composite of reinfarction, need for revascularization, cardiovascular death, or death from any cause. **Results**: This registry-based study included 1102 patients with NSTE-ACS, 32.5% were female. Median Syntax score was 17 (IQR 6-21), with 684 (61%) patients having low (22), respectively. Gender did not correlate with CAD severity as assessed by Syntax score (men: low 59%, medium 18% and high 23% vs. women low 64%, medium 16% and high 20%, p=0.267), nor when assessed as single-vessel or multivessel disease (single-vessel: men 37 vs. women 42%; multi-vessel: men 63% vs. women 58%, p=0.073). After a median follow up of 17 (6-27) months, gender did not impact a MACE incidence during follow up. **Conclusion**: Our real-world data suggests there are no significant gender disparities regarding CAD severity among patients with NSTE-ACS, nor it influences MACE incidence in long-term follow up.

    Literature

    1. Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E. Braunwald’s heart disease: a textbook of cardiovascular medicine. Philadelphia: Elsevier/Saunders; 2015.
    Cardiologia Croatica
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    Do differences related to gender impact coronary angiogram findings and outcomes in patients presenting with non-ST elevation myocardial infarction?

    Extended Abstract
    Issue11-12
    Published
    Pages386
    PDF via DOIhttps://doi.org/10.15836/ccar2024.386
    coronary artery disease
    gender differences
    major adverse cardiac events

    Authors

    Marko Galić*ORCIDGeneral Hospital Slavonski Brod, Slavonski Brod, Croatia
    Ivan ZeljkovićORCIDDubrava University Hospital, Zagreb, Croatia
    Petra BistrovićORCIDDubrava University Hospital, Zagreb, Croatia
    Šime ManolaORCIDDubrava University Hospital, Zagreb, Croatia
    Andrej NovakORCIDDubrava University Hospital, Zagreb, Croatia
    Nikola PavlovićORCIDDubrava University Hospital, Zagreb, Croatia
    Ivana JurinORCIDDubrava University Hospital, Zagreb, Croatia
    Marin PavlovORCIDDubrava University Hospital, Zagreb, Croatia
    Aleksandar BlivajsORCIDDubrava University Hospital, Zagreb, Croatia
    Irzal HadžibrgovićORCIDDubrava University Hospital, Zagreb, Croatia

    *Correspondence email: mgmefos@gmail.com

    Full Text

    Introduction: Data on the prognostic significance of gender among patients with non-ST elevation acute coronary syndrome (NSTE-ACS) are conflicting. Several studies have identified greater mortality rates in women, attributing this trend to the higher incidence of accompanying comorbidities, higher age and suboptimal treatment among female subjects. Conversely, other research contends that even after adjusting for these factors, the prognosis for women remains poorer. Whether these disparities persist in the era of new guidelines and primary or early PCI treatment is yet to be established. (1) The aim of the study was to assess gender disparities in the severity of coronary artery disease (CAD) and major adverse cardiac events’ (MACE) incidence, among patients with NSTE-ACS.

    Patients and Methods: We conducted a registry-based study including patients with NSTE-ACS hospitalized in our centre from January 2017 to January 2023. Data on CAD severity and Syntax score, which evaluates complexity based on coronary anatomy and lesion characteristics, were collected. Follow-up data were acquired through clinical follow up visits or telephone interviews. The MACE was a composite of reinfarction, need for revascularization, cardiovascular death, or death from any cause.

    Results: This registry-based study included 1102 patients with NSTE-ACS, 32.5% were female. Median Syntax score was 17 (IQR 6-21), with 684 (61%) patients having low (22), respectively. Gender did not correlate with CAD severity as assessed by Syntax score (men: low 59%, medium 18% and high 23% vs. women low 64%, medium 16% and high 20%, p=0.267), nor when assessed as single-vessel or multivessel disease (single-vessel: men 37 vs. women 42%; multi-vessel: men 63% vs. women 58%, p=0.073). After a median follow up of 17 (6–27) months, gender did not impact a MACE incidence during follow up.

    Conclusion: Our real-world data suggests there are no significant gender disparities regarding CAD severity among patients with NSTE-ACS, nor it influences MACE incidence in long-term follow up.

    Literature

    1. 1.
      Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E. Braunwald’s heart disease: a textbook of cardiovascular medicine. Philadelphia: Elsevier/Saunders; 2015.