title: Influence of gender on prognosis of acute coronary syndromes.
abstract: BACKGROUND
  Ischemic heart disease presents different features in men and women. We analyzed the relation between gender and prognosis in patients who had suffered a high-risk acute coronary syndrome (ACS).
  
  
  METHODS
  This was a prospective analytical cohort study performed at Lozano Blesa University Hospital, Zaragoza, Spain, of 559 patients diagnosed with high-risk ACS with and without ST-segment elevation according to the American College of Cardiology/American Heart Association guidelines. The sample was divided into two groups by gender and differences in epidemiologic, laboratory, electrocardiographic and echocardiographic variables and treatment were recorded. A Cox's proportional hazard model was applied and 6-month mortality was analyzed as the main variable.
  
  
  RESULTS
  The median age was 65.2±12.7 years, and 21.8% were women. Baseline characteristics in women were more unfavorable, with higher GRACE scores, older age, higher prevalence of hypertension, diabetes and heart failure, lower ejection fraction and more renal dysfunction at admission. Women suffered more adverse cardiovascular events (27.9% vs. 15.8%, p=0.002). Sixty-four patients died, 18.9% of the women vs. 9.4% of the men (p=0.004). After multivariate analysis, female gender did not present an independent relation with mortality. Hemoglobin level, renal function, ejection fraction and Killip class >1 presented significant differences.
  
  
  CONCLUSIONS
  Acute syndrome coronary in women has a worse prognosis than in men. Their adverse course is due to their baseline characteristics and not to their gender.
authors.affiliation: Department of Internal Medicine, General Hospital of Defense, Zaragoza, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Cabrerizo-García
authors.affiliation: Head of Department of Internal Medicine, "Lozano Blesa" Universitary Hospital, Zaragoza, Spain.
authors.forename: Juan I
authors.initials: JI
authors.lastname: Pérez-Calvo
authors.affiliation: Intensive Care Unit, "Lozano Blesa" Universitary Hospital, Zaragoza, Spain. Electronic address: bzalbaetayo@gmail.com.
authors.forename: Begoña
authors.initials: B
authors.lastname: Zalba-Etayo
mesh_terms: D054058:Acute Coronary Syndrome; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012727:Sex Characteristics
keywords: Acute coronary syndrome; Age; Fator de risco; Gender; Idade; Prognosis; Prognóstico; Risk factor; Sexo; Sobrevivência; Survival; Síndrome coronária aguda