Your browser doesn't support javascript.
Relations of Sex to Diagnosis and Outcomes in Acute Coronary Syndrome.
J Am Heart Assoc ; 7(6)2018 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-29525782
ABSTRACT

BACKGROUND:

The atypical presentation of women with acute coronary syndrome (ACS) has been related to delayed diagnosis and treatment, which may explain worse outcome compared with men. METHODS AND

RESULTS:

We analyzed pooled data of 2520 patients of 2 prospective cohorts in terms of differences in presentation and management of women and men suggestive of ACS. Using logistic regression, we established 2 diagnostic models and tested their diagnostic performance in both sexes separately. Sex-specific differences in management of patients with ACS were ascertained and a 2-year follow-up was performed. Women were older than men (median 67 versus 61 years, P=0.001), had more often dyspnea (22% versus 18%, P=0.024), nausea or vomiting (26% versus 16%, P=0.001) and radiating chest pain (47% versus 40%, P=0.001). Classical risk factors (smoking, diabetes mellitus, dyslipidemia or known coronary artery disease) were less frequent in women. Diagnostic models showed no significant sex-related differences in diagnostic performance in a "first contact" setting (medical history and symptoms) or after "complete triage" (including ECG and biomarkers). Women with ACS underwent coronary angiography (73.8% versus 84.3%, P<0.001) and revascularization (53.8% versus 70.1%, P<0.001) less frequently. Two-year incidence of myocardial infarction and death was similar in both sexes, but revascularization and cardiac rehospitalization were more frequent in men.

CONCLUSIONS:

In a large cohort of patients with suspected ACS, sex differences in clinical presentation did not impair diagnostic accuracy. Two-year outcomes were comparable. Our findings suggest a benefit of chest pain units to minimize sex differences in ACS management and prognosis. CLINICAL TRIAL REGISTRATION URL https//www.clinicaltrials.gov. Unique identifiers NCT02355457 (BACC), NCT03227159 (stenoCardia).
Assuntos

Similares

MEDLINE

...
LILACS

LIS

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Síndrome Coronariana Aguda Tipo de estudo: Incidence_studies Aspecto clínico: Diagnóstico / Etiologia / Predição / Prognóstico / Terapia Limite: Idoso / Feminino / Humanos / Masculino / Meia-Idade País/Região como assunto: Europa Idioma: Inglês Ano de publicação: 2018 Tipo de documento: Artigo País de afiliação: Alemanha