Sex and age differences and outcomes in acute coronary syndromes

2016
Authors
Vasiljević-Pokrajcić, ZoranaMickovski, Nataša
Davidović, Goran

Asanin, Milika
Stefanović, Branislav
Krljanac, Gordana

Radosavljević-Radovanović, Mina
Radovanović, Nebojša
Lasica, Ratko
Milanović, Slađan

Bjekić, Jovana

Majstorovic-Stakić, Marta
Trifunović, Danijela
Karadzić, Ana
Rajić, Dubravka
Milošević, Aleksandra
Zdravković, Marija

Sarić, Jelena
Bugiardini, Raffaele

Article (Published version)

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Background: There is conflicting information about sex differences in presentation, treatment, and outcome after acute coronary syndromes (ACS) in the era of reperfusion therapy and percutaneous coronary intervention. The aim of this study was to examine presentation, acute therapy, and outcomes of men and women with ACS with special emphasis on their relationship with younger age ( lt = 65 years). Methods: From January 2010 to June 2015, we enrolled 5140 patients from 3 primary PCI capable hospitals. Patients were registered according to the International Survey of Acute Coronary Syndrome in Transitional Countries (ISACS-TC) registry protocol (ClinicalTrials.gov: NCT01218776). The primary outcome was the incidence of in-hospital mortality. Results: The study population was constituted by 2876 patients younger than 65 years and 2294 patients older. Women were older than men in both the young (56.2 +/- 6.6 vs. 54.1 +/- 7.4) and old (74.9 +/- 6.4 vs. 73.6 +/- 6.0) age groups. There were ...3421 (66.2%) patients with ST elevation ACS (STE-ACS) and 1719 (33.8%) patients without ST elevation ACS (NSTE-ACS). In STE-ACS, the percentage of patients who failed to receive reperfusion was higher in women than in men either in the young (21.7% vs. 15.8%) than in the elderly (35.2% vs. 29.6%). There was a significant higher mortality in women in the younger age group (age-adjusted OR 1.52, 95% CI: 1.01-2.29), but there was no sex difference in the older group (age-adjusted OR 1.10, 95% CI: 0.87-1.41). Significantly sex differences in mortality were not seen in NSTE-ACS patients. Conclusions: In-hospital mortality from ACS is not different between older men and women. A higher short-term mortality can be seen only in women with STEMI and age of 65 or less.
Keywords:
Acute coronary syndrome / Sex differences / Age differences / OutcomesSource:
International Journal of Cardiology, 2016, 217, S27-S31Publisher:
- Elsevier Ireland Ltd, Clare
Funding / projects:
- Acute coronary syndrome - acute myocardial infarction and unstable angina pectoris: modern diagnostic methods and therapeutic options for better survival of patients and location and the possibility of Serbia as a country in transition (RS-175084)
- Investigation of antihypertensiv? and renoprotectiv? potential of natural and synthetic compounds in the experimental models of cardiovascular and renal diseases (RS-175096)
- Noninvasive modulation of cortical excitability and plasticity - Noninvasive neuromodulation of the CNS in the study of physiological mechanisms, diagnosis and treatment (RS-175012)
DOI: 10.1016/j.ijcard.2016.06.217
ISSN: 0167-5273
PubMed: 27395070
WoS: 000382211500007
Scopus: 2-s2.0-84979699716
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Institution/Community
Institut za medicinska istraživanjaTY - JOUR AU - Vasiljević-Pokrajcić, Zorana AU - Mickovski, Nataša AU - Davidović, Goran AU - Asanin, Milika AU - Stefanović, Branislav AU - Krljanac, Gordana AU - Radosavljević-Radovanović, Mina AU - Radovanović, Nebojša AU - Lasica, Ratko AU - Milanović, Slađan AU - Bjekić, Jovana AU - Majstorovic-Stakić, Marta AU - Trifunović, Danijela AU - Karadzić, Ana AU - Rajić, Dubravka AU - Milošević, Aleksandra AU - Zdravković, Marija AU - Sarić, Jelena AU - Bugiardini, Raffaele PY - 2016 UR - http://rimi.imi.bg.ac.rs/handle/123456789/743 AB - Background: There is conflicting information about sex differences in presentation, treatment, and outcome after acute coronary syndromes (ACS) in the era of reperfusion therapy and percutaneous coronary intervention. The aim of this study was to examine presentation, acute therapy, and outcomes of men and women with ACS with special emphasis on their relationship with younger age ( lt = 65 years). Methods: From January 2010 to June 2015, we enrolled 5140 patients from 3 primary PCI capable hospitals. Patients were registered according to the International Survey of Acute Coronary Syndrome in Transitional Countries (ISACS-TC) registry protocol (ClinicalTrials.gov: NCT01218776). The primary outcome was the incidence of in-hospital mortality. Results: The study population was constituted by 2876 patients younger than 65 years and 2294 patients older. Women were older than men in both the young (56.2 +/- 6.6 vs. 54.1 +/- 7.4) and old (74.9 +/- 6.4 vs. 73.6 +/- 6.0) age groups. There were 3421 (66.2%) patients with ST elevation ACS (STE-ACS) and 1719 (33.8%) patients without ST elevation ACS (NSTE-ACS). In STE-ACS, the percentage of patients who failed to receive reperfusion was higher in women than in men either in the young (21.7% vs. 15.8%) than in the elderly (35.2% vs. 29.6%). There was a significant higher mortality in women in the younger age group (age-adjusted OR 1.52, 95% CI: 1.01-2.29), but there was no sex difference in the older group (age-adjusted OR 1.10, 95% CI: 0.87-1.41). Significantly sex differences in mortality were not seen in NSTE-ACS patients. Conclusions: In-hospital mortality from ACS is not different between older men and women. A higher short-term mortality can be seen only in women with STEMI and age of 65 or less. PB - Elsevier Ireland Ltd, Clare T2 - International Journal of Cardiology T1 - Sex and age differences and outcomes in acute coronary syndromes EP - S31 SP - S27 VL - 217 DO - 10.1016/j.ijcard.2016.06.217 UR - conv_3835 ER -
@article{ author = "Vasiljević-Pokrajcić, Zorana and Mickovski, Nataša and Davidović, Goran and Asanin, Milika and Stefanović, Branislav and Krljanac, Gordana and Radosavljević-Radovanović, Mina and Radovanović, Nebojša and Lasica, Ratko and Milanović, Slađan and Bjekić, Jovana and Majstorovic-Stakić, Marta and Trifunović, Danijela and Karadzić, Ana and Rajić, Dubravka and Milošević, Aleksandra and Zdravković, Marija and Sarić, Jelena and Bugiardini, Raffaele", year = "2016", abstract = "Background: There is conflicting information about sex differences in presentation, treatment, and outcome after acute coronary syndromes (ACS) in the era of reperfusion therapy and percutaneous coronary intervention. The aim of this study was to examine presentation, acute therapy, and outcomes of men and women with ACS with special emphasis on their relationship with younger age ( lt = 65 years). Methods: From January 2010 to June 2015, we enrolled 5140 patients from 3 primary PCI capable hospitals. Patients were registered according to the International Survey of Acute Coronary Syndrome in Transitional Countries (ISACS-TC) registry protocol (ClinicalTrials.gov: NCT01218776). The primary outcome was the incidence of in-hospital mortality. Results: The study population was constituted by 2876 patients younger than 65 years and 2294 patients older. Women were older than men in both the young (56.2 +/- 6.6 vs. 54.1 +/- 7.4) and old (74.9 +/- 6.4 vs. 73.6 +/- 6.0) age groups. There were 3421 (66.2%) patients with ST elevation ACS (STE-ACS) and 1719 (33.8%) patients without ST elevation ACS (NSTE-ACS). In STE-ACS, the percentage of patients who failed to receive reperfusion was higher in women than in men either in the young (21.7% vs. 15.8%) than in the elderly (35.2% vs. 29.6%). There was a significant higher mortality in women in the younger age group (age-adjusted OR 1.52, 95% CI: 1.01-2.29), but there was no sex difference in the older group (age-adjusted OR 1.10, 95% CI: 0.87-1.41). Significantly sex differences in mortality were not seen in NSTE-ACS patients. Conclusions: In-hospital mortality from ACS is not different between older men and women. A higher short-term mortality can be seen only in women with STEMI and age of 65 or less.", publisher = "Elsevier Ireland Ltd, Clare", journal = "International Journal of Cardiology", title = "Sex and age differences and outcomes in acute coronary syndromes", pages = "S31-S27", volume = "217", doi = "10.1016/j.ijcard.2016.06.217", url = "conv_3835" }
Vasiljević-Pokrajcić, Z., Mickovski, N., Davidović, G., Asanin, M., Stefanović, B., Krljanac, G., Radosavljević-Radovanović, M., Radovanović, N., Lasica, R., Milanović, S., Bjekić, J., Majstorovic-Stakić, M., Trifunović, D., Karadzić, A., Rajić, D., Milošević, A., Zdravković, M., Sarić, J.,& Bugiardini, R.. (2016). Sex and age differences and outcomes in acute coronary syndromes. in International Journal of Cardiology Elsevier Ireland Ltd, Clare., 217, S27-S31. https://doi.org/10.1016/j.ijcard.2016.06.217 conv_3835
Vasiljević-Pokrajcić Z, Mickovski N, Davidović G, Asanin M, Stefanović B, Krljanac G, Radosavljević-Radovanović M, Radovanović N, Lasica R, Milanović S, Bjekić J, Majstorovic-Stakić M, Trifunović D, Karadzić A, Rajić D, Milošević A, Zdravković M, Sarić J, Bugiardini R. Sex and age differences and outcomes in acute coronary syndromes. in International Journal of Cardiology. 2016;217:S27-S31. doi:10.1016/j.ijcard.2016.06.217 conv_3835 .
Vasiljević-Pokrajcić, Zorana, Mickovski, Nataša, Davidović, Goran, Asanin, Milika, Stefanović, Branislav, Krljanac, Gordana, Radosavljević-Radovanović, Mina, Radovanović, Nebojša, Lasica, Ratko, Milanović, Slađan, Bjekić, Jovana, Majstorovic-Stakić, Marta, Trifunović, Danijela, Karadzić, Ana, Rajić, Dubravka, Milošević, Aleksandra, Zdravković, Marija, Sarić, Jelena, Bugiardini, Raffaele, "Sex and age differences and outcomes in acute coronary syndromes" in International Journal of Cardiology, 217 (2016):S27-S31, https://doi.org/10.1016/j.ijcard.2016.06.217 ., conv_3835 .