title: Gender disparities in acute coronary syndrome: a closing gap in the short-term outcome.
abstract: OBJECTIVE
  The aim of the present study was to analyze gender disparities in a large cohort of acute coronary syndrome (ACS) patients from the Zurich Acute Coronary Syndrome (Z-ACS) Registry.
  
  
  METHODS
  Gender disparities in ACS were examined. The primary endpoint included in-hospital death rate, and the secondary endpoint major adverse cardiac and cerebrovascular events (MACCEs) at 30-day follow-up. Furthermore, independent predictors for MACCEs and death were identified.
  
  
  RESULTS
  In total, 2612 patients with ACS were identified. Out of these, 23% were women. The mean age was higher in women (68.6 ± 12.2; P < 0.001). Troponin-T on admission (1.33 ± 4.64 vs. 1.19 ± 3.04 μg/l; P = 0.002) and N-terminal of the prohormone brain natriuretic peptide on admission (3456.2 ± 7286.7 vs. 1665.6 ± 4800.6 ng/l; P < 0.001) were higher in women compared with men. Single-vessel disease was more common in women (44.9 vs. 39.7%; P = 0.023) and, conversely, multivessel disease was more prevalent in male patients as compared with their female counterparts (59.4 vs. 54.4%; P = 0.029). At discharge, men were more likely prescribed statins (89.4 vs. 85.2%; P = 0.004). Overall mortality and MACCEs were similar for both genders. In women, peak creatine kinase and peak C-reactive protein emerged as independent predictors for MACCEs and SBP on admission, and maximal C-reactive protein and use of glycoprotein IIb/IIIa inhibitors (GPIIb/IIIa) as strong independent predictors for in-hospital death.
  
  
  CONCLUSIONS
  The present results suggest a closing gap in short-term outcome and improvement in cardiac care between women and men. Nonetheless, differences in treatment strategies continue to exist, particularly pertaining to statin regimens at discharge, which might potentially have a powerful impact on long-term outcomes and gender disparities.
authors.affiliation: aDepartment of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland bUniversity of California Davis Medical Center, California, USA cAltstaetten Hospital, Department for Internal Medicine, Division of Cardiology, Altstaetten, Switzerland.
authors.forename: Jelena R
authors.initials: JR
authors.lastname: Ghadri
authors.forename: Annahita
authors.initials: A
authors.lastname: Sarcon
authors.forename: Milosz
authors.initials: M
authors.lastname: Jaguszewski
authors.forename: Johanna
authors.initials: J
authors.lastname: Diekmann
authors.forename: Roxana D
authors.initials: RD
authors.lastname: Bataiosu
authors.forename: Jens
authors.initials: J
authors.lastname: Hellermann
authors.forename: Adam
authors.initials: A
authors.lastname: Csordas
authors.forename: Lukas
authors.initials: L
authors.lastname: Baumann
authors.forename: Aline A
authors.initials: AA
authors.lastname: Schöni
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Christian
authors.initials: C
authors.lastname: Templin
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012042:Registries; D012737:Sex Factors; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome