[Sex differences in mortality at one-month and at one-year after an acute coronary syndrome].
OBJECTIVE
We aimed to delineate the sex differences in short-term (one-month) and long-term (one-year) cardiac death after an acute coronary syndrome.


METHODS
After the publication of the new myocardial infarction definition, we prospectively analyzed 1,324 consecutive patients admitted with a diagnosis of acute coronary syndrome to a tertiary hospital. 483 (37%) of these patients had myocardial infarction with ST-elevation, 439 (33%) had myocardial infarction without ST elevation (troponin I > 1 ng/ml) and 402 (30%) had an unstable angina (troponin I < 1 ng/ml).


RESULTS
Within 1-year of follow-up, 177 deaths (13.4%) were detected. There was a similar rate of cardiac death in female and male patients with 'non-ST elevation myocardial infarction' (one-month: 9.7% vs 7.1%, p = NS; one-year: 16.7% vs 13.2%, p = NS) and with unstable angina (one-month: 3% vs 1.9%, p = NS; one-year: 3% vs 5.6%, p = NS). Among patients with 'ST-elevation myocardial infarction' women showed a higher rate of cardiac death at one-month (21.5% vs 9.8%; p < 0.0001) and at one-year (28.9% vs 14.1%, p < 0.0001) than men. In the multivariate analysis, independent predictors of cardiac death in 'ST-elevation myocardial infarction' at one-year were age > 70 years (p < 0.0001), Killip class > 1 (p < 0.0001) and lack of reperfusion (p = 0.003) but not having a female sex.


CONCLUSIONS
Patients with 'non-ST elevation acute coronary syndromes' did not display sex differences with regard to mortality. Women with 'ST-elevation myocardial infarction' had a higher mortality; however, these differences were not independently related to a female sex but to a worse baseline clinical profile and a lesser rate of reperfusion.
Bodí
Vicent
V
Servicio de Cardiología, Hospital Clínic i Universitari, Universitat de Valencia, Spain. vicentbodi@hotmail.com
Sanchis
Juan
J
Llàcer
Angel
A
Núñez
Julio
J
Fácila
Lorenzo
L
Pellicer
Mauricio
M
Bertomeu
Vicente
V
Bosch
María J
MJ
García
Diego
D
Chorro
Francisco J
FJ
D000208:Acute Disease; D000368:Aged; D000789:Angina, Unstable / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology*; D011446:Prospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D013577:Syndrome; D013997:Time Factors