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Sex and age differences and outcomes in acute coronary syndromes

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2016
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Authors
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
Article (Published version)
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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.

Keywords:
Acute coronary syndrome / Sex differences / Age differences / Outcomes
Source:
International Journal of Cardiology, 2016, 217, S27-S31
Publisher:
  • 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
[ Google Scholar ]
13
7
URI
http://rimi.imi.bg.ac.rs/handle/123456789/743
Collections
  • Radovi istraživača / Researchers' publications
Institution/Community
Institut za medicinska istraživanja
TY  - 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 .

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