title: Health-related quality of life in premature acute coronary syndrome: does patient sex or gender really matter?
abstract: BACKGROUND
  Limited data exist as to the relative contribution of sex and gender on health-related quality of life (HRQL) among patients with acute coronary syndrome (ACS). This study aims to evaluate the effect of sex and gender-related variables on long-term HRQL among young adults with ACS.
  
  
  RESULTS
  GENESIS-PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond-Premature Acute Coronary SYndrome) is a multicenter, prospective cohort study (January 2009 to August 2013) of adults aged 18 to 55 years, hospitalized with ACS. HRQL was measured at baseline, 1, 6, and 12 months using the Short Form-12 and Seattle Angina Questionnaire (SAQ) among 1213 patients. Median age was 49 years. Women reported worse HRQL than men over time post-ACS, both in terms of physical and mental functioning. Gender-related factors were more likely to be predictors of HRQL than sex. Femininity score, social support, and housework responsibility were the most common gender-related predictors of HRQL at 12 months. We observed an interaction between female sex and social support (β=0.44 [95% confidence interval, 0.01, 0.88]; P=0.047) for the physical limitation subscale of the SAQ.
  
  
  CONCLUSIONS
  Young women with ACS report significantly poorer HRQL than young men. Gender appears to be more important than sex in predicting long-term HRQL post-ACS. Specific gender-related factors, such as social support, may be amenable to interventions and could improve the HRQL of patients with premature ACS.
authors: Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.).
authors: Sylvie S L
authors: SS
authors: Leung Yinko
authors: Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.).
authors: Roxanne
authors: R
authors: Pelletier
authors: Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.).
authors: Hassan
authors: H
authors: Behlouli
authors: Faculties of Nursing, Medicine and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (C.M.N.).
authors: Colleen M
authors: CM
authors: Norris
authors: Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (K.H.H.) Providence Health Care Research Institute, St. Paul's Hospital, Vancouver British, Columbia, Canada (K.H.H.).
authors: Karin H
authors: KH
authors: Humphries
authors: Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.) Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada (L.P.).
authors: Louise
authors: L
authors: Pilote
mesh_terms: D054058:Acute Coronary Syndrome; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D057227:Femininity; D005783:Gender Identity; D006304:Health Status; D006796:Household Work; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D057228:Masculinity; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: angina; cardiovascular diseases; myocardial infarction; sex