Among elderly ACS patients (>75 years) referred for coronary angiography, women had significantly lower 1-year MACCE rates compared to men (15% vs 23%; adjusted OR 0.48; 95% CI 0.26-0.90; P=0.02).
Cohort (n=2,168)
Does female gender improve 1-year MACCE outcomes compared to male gender in elderly patients with acute coronary syndromes referred for coronary angiography?
Elderly women with ACS referred for coronary angiography have significantly lower 1-year MACCE and cardiovascular mortality rates compared to elderly men, suggesting an attenuation of the historical gender gap in ACS management.
Estimación del efecto: adjusted OR 0.48 (95% CI 0.26-0.90)
Tasa de eventos absoluta: 15% vs 23%
valor p: p=0.02
OBJECTIVES: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Stähli et al. (Fri,) conducted a cohort in Acute coronary syndromes (ACS) (n=2,168). Female gender vs. Male gender was evaluated on Major adverse cardiovascular and cerebrovascular events (MACCE) (adjusted OR 0.48, 95% CI 0.26-0.90, p=0.02). Among elderly ACS patients (>75 years) referred for coronary angiography, women had significantly lower 1-year MACCE rates compared to men (15% vs 23%; adjusted OR 0.48; 95% CI 0.26-0.90; P=0.02).
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