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Revascularization and prognosis in female patients with non-ST-segment elevation acute coronary syndromes.
Rev Port Cardiol 2003; 22(3):367-74RP

Abstract

BACKGROUND

After an acute myocardial infarction, women have a higher risk of death or reinfarction. In unstable angina, female gender seems to be protective. On the other hand, studies suggest that women are less frequently given coronary angiography.

OBJECTIVES

To evaluate, in our population of patients admitted for non-ST-elevation acute coronary syndrome (ACS), the influence of gender in prognosis and in the use of invasive procedures.

POPULATION AND METHODS

We studied 387 consecutive patients, 20% female, admitted to our ICU for non-ST-segment elevation ACS. We compared demographic and clinical variables, the use of coronary angiography and myocardial revascularization procedures, according to gender. We analyzed the combined endpoint of death or (re)infarction at 30 days and for the total follow-up period of 420 +/- 322 days.

RESULTS

The women were older (65 +/- 10 vs. 62 +/- 11 years, p = 0.05), and more frequently had a history of hypertension (p = 0.005), diabetes mellitus (p = 0.07), previous surgical myocardial revascularization (p = 0.048) and higher heart rate on admission (p = 0.048). Smoking was more frequent in men (p < 0.001). The most frequent diagnosis was unstable angina; 76% for women vs. 66% in men (p = 0.12). Coronary angiography was performed during hospitalization in 87%, in both genders. Myocardial revascularization was performed in 62% of the women and 69% of the men (p = 0.26). At 30 days, the frequency of death or (re)infarction was 11% for women and 10% for men (log-rank, p = 0.79). By multivariate analysis (Cox regression), the independent predictors of outcome at 30 days were previous myocardial revascularization and heart failure on admission. For the total follow-up, we did not find differences in the occurrence of the combined endpoint, and the independent predictors of outcome were previous surgical myocardial revascularization, heart failure on admission, ST segment depression on the admission ECG and surgical myocardial revascularization.

CONCLUSIONS

In non-ST-elevation ACS, women present some differences in their demographic and clinical profile. We did not find differences in the use of invasive procedures or prognosis in the short and medium term.

Authors+Show Affiliations

Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng por

PubMed ID

12847878

Citation

Timóteo, Ana Teresa, et al. "Revascularization and Prognosis in Female Patients With non-ST-segment Elevation Acute Coronary Syndromes." Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, vol. 22, no. 3, 2003, pp. 367-74.
Timóteo AT, Ferreira J, Aguiar C, et al. Revascularization and prognosis in female patients with non-ST-segment elevation acute coronary syndromes. Rev Port Cardiol. 2003;22(3):367-74.
Timóteo, A. T., Ferreira, J., Aguiar, C., Almeida, M. d. e. . S., Ribeiro, M. A., Cavaco, D. M., ... Seabra-Gomes, R. (2003). Revascularization and prognosis in female patients with non-ST-segment elevation acute coronary syndromes. Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, 22(3), pp. 367-74.
Timóteo AT, et al. Revascularization and Prognosis in Female Patients With non-ST-segment Elevation Acute Coronary Syndromes. Rev Port Cardiol. 2003;22(3):367-74. PubMed PMID: 12847878.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Revascularization and prognosis in female patients with non-ST-segment elevation acute coronary syndromes. AU - Timóteo,Ana Teresa, AU - Ferreira,Jorge, AU - Aguiar,Carlos, AU - Almeida,Manuel de Sousa, AU - Ribeiro,Miguel Almeida, AU - Cavaco,Diogo Magalhães, AU - Trabulo,Marisa, AU - Seabra-Gomes,Ricardo, PY - 2003/7/10/pubmed PY - 2003/10/10/medline PY - 2003/7/10/entrez SP - 367 EP - 74 JF - Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology JO - Rev Port Cardiol VL - 22 IS - 3 N2 - BACKGROUND: After an acute myocardial infarction, women have a higher risk of death or reinfarction. In unstable angina, female gender seems to be protective. On the other hand, studies suggest that women are less frequently given coronary angiography. OBJECTIVES: To evaluate, in our population of patients admitted for non-ST-elevation acute coronary syndrome (ACS), the influence of gender in prognosis and in the use of invasive procedures. POPULATION AND METHODS: We studied 387 consecutive patients, 20% female, admitted to our ICU for non-ST-segment elevation ACS. We compared demographic and clinical variables, the use of coronary angiography and myocardial revascularization procedures, according to gender. We analyzed the combined endpoint of death or (re)infarction at 30 days and for the total follow-up period of 420 +/- 322 days. RESULTS: The women were older (65 +/- 10 vs. 62 +/- 11 years, p = 0.05), and more frequently had a history of hypertension (p = 0.005), diabetes mellitus (p = 0.07), previous surgical myocardial revascularization (p = 0.048) and higher heart rate on admission (p = 0.048). Smoking was more frequent in men (p < 0.001). The most frequent diagnosis was unstable angina; 76% for women vs. 66% in men (p = 0.12). Coronary angiography was performed during hospitalization in 87%, in both genders. Myocardial revascularization was performed in 62% of the women and 69% of the men (p = 0.26). At 30 days, the frequency of death or (re)infarction was 11% for women and 10% for men (log-rank, p = 0.79). By multivariate analysis (Cox regression), the independent predictors of outcome at 30 days were previous myocardial revascularization and heart failure on admission. For the total follow-up, we did not find differences in the occurrence of the combined endpoint, and the independent predictors of outcome were previous surgical myocardial revascularization, heart failure on admission, ST segment depression on the admission ECG and surgical myocardial revascularization. CONCLUSIONS: In non-ST-elevation ACS, women present some differences in their demographic and clinical profile. We did not find differences in the use of invasive procedures or prognosis in the short and medium term. SN - 0870-2551 UR - https://www.unboundmedicine.com/medline/citation/12847878/Revascularization_and_prognosis_in_female_patients_with_non_ST_segment_elevation_acute_coronary_syndromes_ DB - PRIME DP - Unbound Medicine ER -