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

Stähli, Barbara E; Wischnewsky, Manfred B; Jakob, Philipp; Klingenberg, Roland; Obeid, Slayman; Heg, Dik; Räber, Lorenz; Windecker, Stephan; Mach, François; Gencer, Baris; Nanchen, David; Jüni, Peter; Landmesser, Ulf; Matter, Christian M; Lüscher, Thomas F; Maier, Willibald (2019). Gender and age differences in outcomes of patients with acute coronary syndromes referred for coronary angiography. Catheterization and cardiovascular interventions, 93(1), pp. 16-24. Wiley-Blackwell 10.1002/ccd.27712

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OBJECTIVES 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). METHODS 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. RESULTS 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). CONCLUSIONS 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Heg, Dierik Hans; Räber, Lorenz; Windecker, Stephan and Jüni, Peter

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1522-1946

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

24 Oct 2018 15:06

Last Modified:

21 Nov 2019 04:19

Publisher DOI:

10.1002/ccd.27712

PubMed ID:

30291678

Uncontrolled Keywords:

acute coronary syndrome coronary artery disease elderly patients gender

BORIS DOI:

10.7892/boris.120535

URI:

https://boris.unibe.ch/id/eprint/120535

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