Comparison of Inhospital and 12- and 36-Month Outcomes After Acute Coronary Syndrome in Men Versus Women <40 Years (from the PL-ACS Registry).
The study was aimed to compare the characteristics and inhospital and 12- and 36-month outcomes of men and women <40 years with acute coronary syndrome (ACS). The analysis involved 932 patients <40 years with ACS in the Silesia region enrolled into the ongoing, prospective Polish Registry of Acute Coronary Syndromes from January 2006 to December 2014. The composite end point involved death, recurrence of ACS, a need for percutaneous coronary intervention, and coronary artery bypass graft surgery within 12 and 36 months after ACS. Compared with men, women <40 years were less frequently smokers (66.1% vs 55.4%, p = 0008), had older average age (35.6 ± 4.2 vs 34.7 ± 4.4, p = 0.002), more often had unstable angina at admission (29.1% vs 19.3%, p <0.001), and less frequently had ST-elevation myocardial infarction: 41.3% versus 51.3%, p = 0.02, at admission. There was no significant difference in the mortality (4.8% vs 3.1%, p = 0.29) and the composite end point (21.6% vs 16.0%, p = 0.14) within 12 months after ACS. Compared with men, women had a higher incidence of the composite end point (28.4% vs 20.1%, p = 0.04) and indicated a tendency of a higher mortality within the 36-month follow-up period (9.2% vs 5.0%, p = 0.055). Female gender turned out to be an independent risk factor of death in the multivariate analysis (hazard ratio 2.76, 95% confidence interval 1.21 to 6.31, p <0.016). In conclusion, women had a higher incidence of the composite end point and showed a tendency toward a higher mortality than the men within the 36-month follow-up period.
Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland. Electronic address: przemyslaw.t@wp.pl.
Przemysław
P
Trzeciak
First Clinical Department of Cardiology, Świętokrzyskie Centre of Cardiology, Kielce, Poland; University of Health Sciences, Jan Kochanowski University, Kielce, Poland.
Beata
B
Wożakowska-Kapłon
Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
Jacek
J
Niedziela
Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
Marek
M
Gierlotka
Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
Michał
M
Hawranek
Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
Andrzej
A
Lekston
Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
Jarosław
J
Wasilewski
Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
Lech
L
Poloński
Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
Mariusz
M
Gąsior
D054058:Acute Coronary Syndrome / Q000401:mortality* / Q000628:therapy*; D000328:Adult; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009204:Myocardial Revascularization; D010359:Patient Readmission / Q000706:statistics & numerical data; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology; D016896:Treatment Outcome