Sex Differences in Characteristics and Outcomes among Low-Risk Non-ST-Elevation Acute Coronary Syndrome Patients during Long Term Follow-Up
Previous heterogenous studies show conflicting data about sex-based outcomes of non-ST-elevation acute coronary syndrome (NSTE-ACS) patients. This study evaluated 300 NSTE-ACS patients undergoing a coronary angiography between September 2012 and May 2015 that were managed with all-treatment strategi...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-06-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/10/13/2802 |
| _version_ | 1797528658164842496 |
|---|---|
| author | Ivica Kristić Andrija Matetic Nikola Crnčević Frane Runjić Ozren Polašek Mislav Vrsalovic |
| author_facet | Ivica Kristić Andrija Matetic Nikola Crnčević Frane Runjić Ozren Polašek Mislav Vrsalovic |
| author_sort | Ivica Kristić |
| collection | DOAJ |
| description | Previous heterogenous studies show conflicting data about sex-based outcomes of non-ST-elevation acute coronary syndrome (NSTE-ACS) patients. This study evaluated 300 NSTE-ACS patients undergoing a coronary angiography between September 2012 and May 2015 that were managed with all-treatment strategies. The sample was stratified by sex and analyzed for the baseline characteristics and outcomes. The main outcome included major adverse cardiovascular and cerebrovascular events (MACCE), which were a composite of cardiac death, nonfatal myocardial infarction, ischemic stroke or urgent coronary revascularization. The female patients were older (median of 69.0 vs. 63.0 years, <i>p</i> = 0.008) and had lower values of BMI (median of 26.3 vs. 28.2 kg/m<sup>2</sup>, <i>p</i> < 0.001) and eGFR (76.44 ± 22.43 vs. 94.04 ± 27.91 mL/min, <i>p</i> < 0.001). There was no significant difference in the treatment strategies, angiographic characteristics and discharge therapy between the groups (<i>p</i> > 0.05). The female patients had significantly higher unadjusted rates of ischemic stroke (4.2% vs. 0.5%, <i>p</i> = 0.023), cardiac mortality (11.3%, vs. 3.9%, <i>p</i> = 0.022) and MACCE (33.8%, vs. 19.5%, <i>p</i> = 0.014); female sex was a significant predictor of MACCE in the univariate analysis (HR 1.86, 95%CI 1.12–3.09, <i>p</i> = 0.014); and the cumulative incidence of MACCE was higher in female patients (<i>p</i> = 0.014). After the adjustment, the predictive effect of female sex became non-significant (HR 1.60, 95%CI 0.94–2.73, <i>p</i> = 0.083), while there was no difference in the cumulative incidence of MACCE among the propensity score matched cohort (<i>p</i> = 0.177). Female NSTE-ACS patients have worse long-term outcomes compared to their male counterparts. However, the differences disappear after adjustment and propensity score matching. Continuing efforts and health measures are required to alleviate any sex-based differences in the NSTE-ACS population. |
| first_indexed | 2024-03-10T10:02:30Z |
| format | Article |
| id | doaj.art-3d54931166ca4db9af5c7aeef7217edb |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T10:02:30Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3d54931166ca4db9af5c7aeef7217edb2023-11-22T01:49:59ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011013280210.3390/jcm10132802Sex Differences in Characteristics and Outcomes among Low-Risk Non-ST-Elevation Acute Coronary Syndrome Patients during Long Term Follow-UpIvica Kristić0Andrija Matetic1Nikola Crnčević2Frane Runjić3Ozren Polašek4Mislav Vrsalovic5Department of Cardiology, University Hospital of Split, 21000 Split, CroatiaDepartment of Cardiology, University Hospital of Split, 21000 Split, CroatiaDepartment of Cardiology, University Hospital of Split, 21000 Split, CroatiaDepartment of Cardiology, University Hospital of Split, 21000 Split, CroatiaDepartment of Public Health, University of Split School of Medicine, 21000 Split, CroatiaDepartment of Cardiology, Sestre Milosrdnice University Hospital Center, Vinogradska cesta 29, 10000 Zagreb, CroatiaPrevious heterogenous studies show conflicting data about sex-based outcomes of non-ST-elevation acute coronary syndrome (NSTE-ACS) patients. This study evaluated 300 NSTE-ACS patients undergoing a coronary angiography between September 2012 and May 2015 that were managed with all-treatment strategies. The sample was stratified by sex and analyzed for the baseline characteristics and outcomes. The main outcome included major adverse cardiovascular and cerebrovascular events (MACCE), which were a composite of cardiac death, nonfatal myocardial infarction, ischemic stroke or urgent coronary revascularization. The female patients were older (median of 69.0 vs. 63.0 years, <i>p</i> = 0.008) and had lower values of BMI (median of 26.3 vs. 28.2 kg/m<sup>2</sup>, <i>p</i> < 0.001) and eGFR (76.44 ± 22.43 vs. 94.04 ± 27.91 mL/min, <i>p</i> < 0.001). There was no significant difference in the treatment strategies, angiographic characteristics and discharge therapy between the groups (<i>p</i> > 0.05). The female patients had significantly higher unadjusted rates of ischemic stroke (4.2% vs. 0.5%, <i>p</i> = 0.023), cardiac mortality (11.3%, vs. 3.9%, <i>p</i> = 0.022) and MACCE (33.8%, vs. 19.5%, <i>p</i> = 0.014); female sex was a significant predictor of MACCE in the univariate analysis (HR 1.86, 95%CI 1.12–3.09, <i>p</i> = 0.014); and the cumulative incidence of MACCE was higher in female patients (<i>p</i> = 0.014). After the adjustment, the predictive effect of female sex became non-significant (HR 1.60, 95%CI 0.94–2.73, <i>p</i> = 0.083), while there was no difference in the cumulative incidence of MACCE among the propensity score matched cohort (<i>p</i> = 0.177). Female NSTE-ACS patients have worse long-term outcomes compared to their male counterparts. However, the differences disappear after adjustment and propensity score matching. Continuing efforts and health measures are required to alleviate any sex-based differences in the NSTE-ACS population.https://www.mdpi.com/2077-0383/10/13/2802sexnon-ST-elevation acute coronary syndromelong-term follow-up |
| spellingShingle | Ivica Kristić Andrija Matetic Nikola Crnčević Frane Runjić Ozren Polašek Mislav Vrsalovic Sex Differences in Characteristics and Outcomes among Low-Risk Non-ST-Elevation Acute Coronary Syndrome Patients during Long Term Follow-Up Journal of Clinical Medicine sex non-ST-elevation acute coronary syndrome long-term follow-up |
| title | Sex Differences in Characteristics and Outcomes among Low-Risk Non-ST-Elevation Acute Coronary Syndrome Patients during Long Term Follow-Up |
| title_full | Sex Differences in Characteristics and Outcomes among Low-Risk Non-ST-Elevation Acute Coronary Syndrome Patients during Long Term Follow-Up |
| title_fullStr | Sex Differences in Characteristics and Outcomes among Low-Risk Non-ST-Elevation Acute Coronary Syndrome Patients during Long Term Follow-Up |
| title_full_unstemmed | Sex Differences in Characteristics and Outcomes among Low-Risk Non-ST-Elevation Acute Coronary Syndrome Patients during Long Term Follow-Up |
| title_short | Sex Differences in Characteristics and Outcomes among Low-Risk Non-ST-Elevation Acute Coronary Syndrome Patients during Long Term Follow-Up |
| title_sort | sex differences in characteristics and outcomes among low risk non st elevation acute coronary syndrome patients during long term follow up |
| topic | sex non-ST-elevation acute coronary syndrome long-term follow-up |
| url | https://www.mdpi.com/2077-0383/10/13/2802 |
| work_keys_str_mv | AT ivicakristic sexdifferencesincharacteristicsandoutcomesamonglowrisknonstelevationacutecoronarysyndromepatientsduringlongtermfollowup AT andrijamatetic sexdifferencesincharacteristicsandoutcomesamonglowrisknonstelevationacutecoronarysyndromepatientsduringlongtermfollowup AT nikolacrncevic sexdifferencesincharacteristicsandoutcomesamonglowrisknonstelevationacutecoronarysyndromepatientsduringlongtermfollowup AT franerunjic sexdifferencesincharacteristicsandoutcomesamonglowrisknonstelevationacutecoronarysyndromepatientsduringlongtermfollowup AT ozrenpolasek sexdifferencesincharacteristicsandoutcomesamonglowrisknonstelevationacutecoronarysyndromepatientsduringlongtermfollowup AT mislavvrsalovic sexdifferencesincharacteristicsandoutcomesamonglowrisknonstelevationacutecoronarysyndromepatientsduringlongtermfollowup |