eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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SCImago Journal & Country Rank
4/2020
vol. 16
 
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Coronary artery disease
abstract:
Clinical research

Gender-related disparities in the treatment and outcomes in patients with non-ST-segment elevation myocardial infarction: results from the Polish Registry of Acute Coronary Syndromes (PL-ACS) in the years 2012–2014

Łukasz Piątek
1, 2
,
Krzysztof Wilczek
3
,
Jacek Kurzawski
2
,
Marek Gierlotka
4
,
Mariusz Gąsior
3
,
Lech Poloński
3
,
Marcin Sadowski
1, 5

1.
The Faculty of Medicine and Health Sciences, The Jan Kochanowski University, Department of Anatomy, Kielce, Poland
2.
2nd Department of Cardiology, Świętokrzyskie Cardiology Centre, Kielce, Poland
3.
3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Disease, Zabrze, Poland
4.
Department of Cardiology, University Hospital, Institute of Medicine, University of Opole, Poland
5.
Catheterisation Laboratory, Świętokrzyskie Cardiology Centre, Kielce, Poland
Arch Med Sci 2020; 16 (4): 781–788
Online publish date: 2020/02/28
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Introduction
Gender-related differences in the treatment of patients with non-ST elevation myocardial infarction (NSTEMI) have been reported in many previous studies despite the fact that an equal approach is recommended in all current guidelines. The aim of the study was to investigate whether gender-related discrepancies in the management of NSTEMI patients have changed.

Material and methods
Between 2012 and 2014 a total of 66,667 patients (38.3% of whom were women) with the final diagnosis of NSTEMI were included into the retrospective analysis of the Polish Registry of Acute Coronary Syndromes (PL-ACS). Differences in clinical profile, treatment, and outcomes were analysed.

Results
Women were older than men and more often had comorbidities. They were less likely to undergo coronary angiography (88.4% vs. 92.1%, p < 0.05) as well as percutaneous coronary intervention (59.6% vs. 71.9%, p < 0.05). In the general population women had also significantly worse in-hospital prognosis as well as in 12-month follow-up. After the age adjustment the outcomes in women were at least as good as in men. In multivariate analysis females had the same risk as men in-hospital RR = 1.02 (95% CI: 0.97–1.08, p = 0.45) and lower in 12-month observation RR = 0.94 (95% CI: 0.92–0.97, p < 0.0001).

Conclusions
In comparison with previous reports on NSTEMI patients, gender-related disparities in the treatment and outcomes were radically reduced. Unadjusted mortality rates were still higher in women as a consequence of their older age. After the age adjustment, mortality ratios were similar in both genders. The long-term prognosis seems to be even better in women.

keywords:

women, elderly, mortality, non-ST elevation myocardial infarction, invasive treatment

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