Titre
Gender and age differences in outcomes of patients with acute coronary syndromes referred for coronary angiography.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Stähli, B.E.
Auteure/Auteur
Wischnewsky, M.B.
Auteure/Auteur
Jakob, P.
Auteure/Auteur
Klingenberg, R.
Auteure/Auteur
Obeid, S.
Auteure/Auteur
Heg, D.
Auteure/Auteur
Räber, L.
Auteure/Auteur
Windecker, S.
Auteure/Auteur
Mach, F.
Auteure/Auteur
Gencer, B.
Auteure/Auteur
Nanchen, D.
Auteure/Auteur
Jüni, P.
Auteure/Auteur
Landmesser, U.
Auteure/Auteur
Matter, C.M.
Auteure/Auteur
Lüscher, T.F.
Auteure/Auteur
Maier, W.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1522-726X
Statut éditorial
Publié
Date de publication
2019-01-01
Volume
93
Numéro
1
Première page
16
Dernière page/numéro d’article
24
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
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).
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.
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).
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.
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.
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).
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.
Sujets
PID Serval
serval:BIB_B166C03E65B4
PMID
Date de création
2018-10-17T08:21:27.213Z
Date de création dans IRIS
2025-05-21T04:53:47Z