Women and men with unstable angina and/or non-ST-elevation myocardial infarction.
BACKGROUND
In unstable angina and/or non-ST-elevation myocardial infarction (UA/NSTEMI), sex-related differences in outcomes are less well known than in ST-elevation myocardial infarction (STEMI), where women experience worse outcomes than men. Our aim was a prospective comparison between men and women with UA/NSTEMI of baseline characteristics, in-hospital complications, mortality, reinfarctions and combined endpoint of mortality and/or reinfarction during hospital stay, at 30 days and at six months.


METHODS
Initial medical treatment was given to 92 men and 47 women with UA/NSTEMI. Percutaneous coronary interventions (PCI) were performed within the first 48 hours in cases of recurrent chest pain and/or rhythmic and/or hemodynamic instability.


RESULTS
Women were significantly older (66.6 +/- 9.6 vs. 59.7 +/- 10.6, P = 0.0001), less physically active (76.6% vs. 91.3%, P = 0.035), with significantly more frequent arterial hypertension (78.7% vs. 51%, P = 0.0039) and insulin-treated diabetes (17% vs. 5.4%, P = 0.0341), but with less likely prior MI (21.3% vs. 48.9%, P = 0.003), smoking (10.6% vs. 32.6%, P = 0.009) and dyslipidemia with HDL-cholesterol < 1.0 mmol/L (25.5% vs. 46.4%, P = 0.015) than men. Though medical and invasive treatments were similar in both sexes, women were at significantly increased risk of in-hospital pulmonary edema (OR 4.16, 95% CI 1.51 to 11.45) but not at increased risk of adverse in-hospital, 30-day and six-month outcomes in comparison with men.


CONCLUSIONS
Women with UA/NSTEMI, being significantly older and with more comorbidity, were at significantly increased risk of in-hospital heart failure but not at increased risk of in-hospital, 30-day and six-month adverse outcomes when compared with men, despite their similar treatments.
Sinkovic
Andreja
A
Department of Medical Intensive Care, General Hospital Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia. andreja.sinkovic@guest.arnes.si
Marinsek
Martin
M
Svensek
Franc
F
D017677:Age Distribution; D000368:Aged; D000789:Angina, Unstable / Q000401:mortality* / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D017524:Slovenia / Q000453:epidemiology