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Association of Sex with Outcome in Elderly Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.
- Source :
-
The American journal of medicine [Am J Med] 2021 Sep; Vol. 134 (9), pp. 1135-1141.e1. Date of Electronic Publication: 2021 May 08. - Publication Year :
- 2021
-
Abstract
- Background: Worse outcomes have been reported for women, compared with men, after an acute coronary syndrome (ACS). Whether this difference persists in elderly patients undergoing similar invasive treatment has not been studied. We investigated sex-related differences in 1-year outcome of elderly acute coronary syndrome patients treated by percutaneous coronary intervention (PCI).<br />Methods: Patients 75 years and older successfully treated with PCI were selected among those enrolled in 3 Italian multicenter studies. Cox regression analysis was used to assess the independent predictive value of sex on outcome at 12-month follow-up.<br />Results: A total of 2035 patients (44% women) were included. Women were older and most likely to present with ST-elevation myocardial infarction (STEMI), diabetes, hypertension, and renal dysfunction; men were more frequently overweight, with multivessel coronary disease, prior myocardial infarction, and revascularizations. Overall, no sex disparity was found about all-cause (8.3% vs 7%, P = .305) and cardiovascular mortality (5.7% vs 4.1%, P = .113). Higher cardiovascular mortality was observed in women after STEMI (8.8%) vs 5%, P = .041), but not after non ST-elevation-ACS (3.5% vs 3.7%, P = .999). A sensitivity analysis excluding patients with prior coronary events (N = 1324, 48% women) showed a significantly higher cardiovascular death in women (5.4% vs 2.9%, P = .025). After adjustment for baseline clinical variables, female sex did not predict adverse outcome.<br />Conclusions: Elderly men and women with ACS show different clinical presentation and baseline risk profile. After successful PCI, unadjusted 1-year cardiovascular mortality was significantly higher in women with STEMI and in those with a first coronary event. However, female sex did not predict cardiovascular mortality after adjustment for the different baseline variables.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Female
Humans
Hypertension epidemiology
Italy epidemiology
Male
Mortality
Overweight epidemiology
Prognosis
Risk Factors
ST Elevation Myocardial Infarction diagnosis
ST Elevation Myocardial Infarction epidemiology
Severity of Illness Index
Acute Coronary Syndrome diagnosis
Acute Coronary Syndrome mortality
Acute Coronary Syndrome surgery
Percutaneous Coronary Intervention methods
Percutaneous Coronary Intervention statistics & numerical data
Risk Assessment methods
Risk Assessment statistics & numerical data
Sex Factors
Subjects
Details
- Language :
- English
- ISSN :
- 1555-7162
- Volume :
- 134
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The American journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 33971166
- Full Text :
- https://doi.org/10.1016/j.amjmed.2021.03.025