Gender-related differences in the management of non-ST-elevation acute coronary syndrome patients.
OBJECTIVE
To compare management and outcome of female and male non-ST-elevation acute coronary syndrome (ACS) patients.


METHODS
FINACS Studies are prospective registries of non-ST-elevation ACS patients conducted in 2001, 2003, and 2005 in nine hospitals.


RESULTS
The studies enrolled 1,399 patients from which 39% were women. During hospitalisation women were treated less often than men with aspirin (odds ratio [OR]) for women 0.60, 95% confidence interval [CI] 0.41 to 0.88, p=0.03). Women underwent less often in-hospital coronary angiography than men (adjusted OR 0.71, 95% CI 0.55 to 0.93, p=0.01). Also in the subgroup of younger (<75 years) high-risk patients, female sex was independent predictor for not performing in-hospital angiography (OR 0.64, 95% CI 0.42 to 0.97, p=0.04). Age-adjusted mortality at 6 months was similar between men and women.


CONCLUSIONS
Compared to men women received less often aspirin. Women were referred less often to in-hospital coronary angiography. Under-use of in-hospital angiography was evident also in patients with high-risk features when guidelines recommend early invasive treatment.
Vikman
Saila
S
Heart Center, Tampere University Hospital, Finland. saila.vikman@pshp.fi
Airaksinen
K E Juhani
KE
Tierala
Ilkka
I
Peuhkurinen
Keijo
K
Majamaa-Voltti
Kirsi
K
Niemelä
Matti
M
Asplund
Sanna
S
Huhtala
Heini
H
Niemelä
Kari
K
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D017023:Coronary Angiography / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin