Gender-Related Differences in Patients Presenting with Suspected Acute Coronary Syndromes: Clinical Presentation, Biomarkers and Diagnosis.
Gender differences in patients presenting with suspected acute coronary syndromes (ACS) have not yet been fully characterized. The aim of this study was to assess gender-related disparities in clinical profiles, biomarkers and diagnoses of patients with suspected ACS.



This single-centre, prospective cohort study included 377 consecutive patients presenting with suspected ACS to the emergency department. Suspected ACS was defined as a request for conventional troponin T (c-cTnT) measurements on clinical grounds.



Women were older than men (p = 0.004), and had a lower prevalence of known coronary artery and peripheral vascular disease (p < 0.05). c-cTnT was positive in 8% of female and in 14% of male patients (p = 0.16), TIMI risk score and cardiac biomarkers including c-cTnT, hs-cTnT, myoglobin, creatine kinase, N-terminal pro-brain natriuretic peptide, myeloid-related protein 8/14 and pregnancy-associated plasma protein A were lower in women (p < 0.05). Women were less frequently diagnosed with ACS (30 vs. 51%), and were not referred for urgent coronary angiography as often as men (p < 0.001). In multivariate analysis, female gender was associated with a lower referral for coronary angiography (HR 0.41, 95% CI 0.23-0.78, p = 0.006).



In patients with suspected ACS, women presented with different biomarker profiles, and were less often diagnosed with ACS and referred to coronary angiography.
Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
B E
BE
Stähli
C
C
Gebhard
K
K
Yonekawa
C E
CE
Gebhard
L A
LA
Altwegg
A
A
von Eckardstein
M
M
Hersberger
I
I
Novopashenny
R
R
Wolters
M B
MB
Wischnewsky
T F
TF
Lüscher
W
W
Maier
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009211:Myoglobin / Q000097:blood; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010147:Pain Measurement / Q000706:statistics & numerical data; D011446:Prospective Studies; D012737:Sex Factors; D020107:Troponin T / Q000097:blood
D015415:Biomarkers; D009211:Myoglobin; D020107:Troponin T; D020097:Natriuretic Peptide, Brain; D003402:Creatine Kinase