title: [Predictors of the use of the early invasive strategy in women with non-ST-elevation acute coronary syndrome].
abstract: OBJECTIVE
  To identify determinants associated to an early invasive strategy in women with acute coronary syndromes without ST elevation (NSTE-ACS).
  
  
  METHODS
  A retrospective cohort study was made. Crude and adjusted analysis of the performance of the early invasive strategy using logistic regression.
  
  
  METHODS
  Coronary Units enrolled in 2010 - 2011 in the ARIAM-SEMICYUC registry.
  
  
  METHODS
  A total of 440 women with NSTE-ACS were studied. Sixteen patients were excluded due to insufficient data, together with 58 patients subjected to elective coronary angiography (> 72 h).
  Demographic parameters, coronary risk factors, previous medication, comorbidity. Clinical, laboratory, hemodynamic and electrocardiographic data of the episode.
  
  
  RESULTS
  Women treated conservatively were of older age, had oral anticoagulation, diabetes, previous coronary lesions, and heart failure (p<0.005), increased baseline bleeding and ischemic risk (p=0.05) and a higher heart rate upon admission (p<0.05). After adjustment, only age > 80 years (OR 0.48, 95% CI 0.27 to 0.82, p=0.009), known coronary lesions (OR 0.47, 95% CI 0.26-0.84, p=0.011), and heart rate (OR 0.98, 95% CI 0.97-0.99, p=0.003) were independently associated to conservative treatment. Smoking (OR 2.50, 95% CI 1.20 to 5.19, p=0.013) and high-risk electrocardiogram (OR 2.96, 95% CI 1.72 to 4.97, p<0.001) were associated to the early invasive strategy. The exclusion of early deaths (<24 h) did not alter these results.
  
  
  CONCLUSIONS
  In women with NSTE ACS, smoking and a high-risk electrocardiogram upon admission were independent factors associated to the early invasive strategy. Previous coronary lesions, age > 80 years and increased heart rate were independent factors associated to conservative treatment.
authors: Servicio de Medicina Intensiva, Hospital General Universitario de Elche, Elche, Alicante, España. Electronic address: emiguelbalsa@gmail.com.
authors: E
authors: E
authors: de Miguel-Balsa
authors: Servicio de Medicina Intensiva, Hospital General Universitario de Elche, Elche, Alicante, España.
authors: A
authors: A
authors: Baeza-Román
authors: Servicio de Medicina Intensiva, Hospital General Universitario de Elche, Elche, Alicante, España.
authors: K
authors: K
authors: Pino-Izquierdo
authors: Servicio de Medicina Intensiva, Hospital General Universitario de Elche, Elche, Alicante, España.
authors: J
authors: J
authors: Latour-Pérez
authors: Servicio de Medicina Intensiva, Hospital General Universitario de Elche, Elche, Alicante, España.
authors: F J
authors: FJ
authors: Coves-Orts
authors: Servicio de Medicina Intensiva, Hospital Sant Joan de Déu, Manresa, Barcelona, España.
authors: J M
authors: JM
authors: Alcoverro-Pedrola
authors: Servicio de Medicina Intensiva, Hospital San Pedro, Logroño, La Rioja, España.
authors: M C
authors: MC
authors: Pavía-Pesquera
authors: Servicio de Medicina Intensiva, Hospital Reina Sofía, Murcia, España.
authors: F
authors: F
authors: Felices-Abad
authors: Servicio de Medicina Intensiva, Hospital de Sagunt, Sagunto, Valencia, España.
authors: R
authors: R
authors: Calvo-Embuena
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D000072658:Non-ST Elevated Myocardial Infarction / Q000453:epidemiology / Q000628:therapy*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Early invasive strategy; Estrategia invasiva precoz; Female gender; Género femenino; Non-ST segment elevation acute coronary syndrome; Registries; Registros; Síndrome coronario agudo sin elevación de ST