Gender and age differences in outcomes of patients with acute coronary syndromes referred for coronary angiography.

Details

Serval ID
serval:BIB_B166C03E65B4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Gender and age differences in outcomes of patients with acute coronary syndromes referred for coronary angiography.
Journal
Catheterization and cardiovascular interventions
Author(s)
Stähli B.E., Wischnewsky M.B., Jakob P., Klingenberg R., Obeid S., Heg D., Räber L., Windecker S., Mach F., Gencer B., Nanchen D., Jüni P., Landmesser U., Matter C.M., Lüscher T.F., Maier W.
ISSN
1522-726X (Electronic)
ISSN-L
1522-1946
Publication state
Published
Issued date
01/01/2019
Peer-reviewed
Oui
Volume
93
Number
1
Pages
16-24
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
The number of elderly patients undergoing coronary revascularization is steadily increasing, and data on the impact of gender on outcomes are scarce. This study sought to assess gender-related differences in outcomes in elderly patients with acute coronary syndromes (ACS).
We investigated outcomes in elderly ACS patients referred for coronary angiography and prospectively enrolled in the Swiss ACS Cohort between December 2009 and October 2012. Adjudicated major adverse cardiovascular and cerebrovascular events (MACCE) included all-cause death, non-fatal myocardial infarction, clinically indicated repeat coronary revascularization, definite stent thrombosis, and transient ischemic attack/stroke.
Among 2,168 patients recruited, 481 (22%) patients were >75 years of age (37% women). In patients >75 years, 1-year MACCE rates were 15% and 23% in women and men (OR 0.59, 95% CI 0.36-0.97, P = 0.04), respectively, and differences remained significant after adjustments for baseline variables (adjusted OR 0.48, 95% CI 0.26-0.90, P = 0.02). Women >75 years had a lower cardiovascular mortality (6% versus 12%, adjusted OR 0.31, 95% CI 0.12-0.81, P = 0.02). In patients ≤75 years, 1-year MACCE rates did not differ between gender (10% and 8% for women and men, adjusted OR 1.28, 95% CI 0.77-2.14, P = 0.34). Rates of TIMI major bleeding for women and men were 4% and 4% in patients >75 years (P = 0.96), and 5% and 3% in those ≤75 years (P = 0.11).
The low rates of MACCE observed in elderly women in this patient cohort suggest that with current interventional strategies the gender gap in ACS management has been attenuated.
Keywords
Acute Coronary Syndrome/diagnostic imaging, Acute Coronary Syndrome/mortality, Acute Coronary Syndrome/therapy, Age Factors, Aged, Aged, 80 and over, Coronary Angiography/trends, Coronary Artery Bypass/adverse effects, Coronary Artery Bypass/mortality, Coronary Artery Bypass/trends, Female, Healthcare Disparities/trends, Humans, Male, Percutaneous Coronary Intervention/adverse effects, Percutaneous Coronary Intervention/mortality, Percutaneous Coronary Intervention/trends, Predictive Value of Tests, Prospective Studies, Referral and Consultation/trends, Risk Assessment, Risk Factors, Sex Factors, Switzerland, Treatment Outcome, acute coronary syndrome, coronary artery disease, elderly patients, gender
Pubmed
Web of science
Create date
17/10/2018 9:21
Last modification date
24/01/2020 6:19
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