Feminine gender characteristics were associated with a higher risk of recurrent ACS over 12 months compared with masculine characteristics (HR 4.50; 95% CI 1.05-19.27), independent of female sex.
Cohort (n=909)
Are feminine gender-related characteristics associated with an increased risk of recurrent ACS and MACE in younger adults with premature ACS?
In younger adults with premature ACS, feminine gender characteristics, but not female biological sex, are associated with an increased risk of recurrent ACS over 12 months.
Hazard Ratio: 4.5 (95% CI 1.05–19.27)
BACKGROUND: "Gender" reflects social norms for women and men, whereas "sex" defines biological characteristics. Gender-related characteristics explain some differences in access to care for premature acute coronary syndrome (ACS); whether they are associated with cardiovascular outcomes is unknown. OBJECTIVES: This study estimated associations between gender and sex with recurrent ACS and major adverse cardiac events (MACE) (e.g., ACS, cardiac mortality, revascularization) over 12 months in patients with ACS. METHODS: We studied 273 women and 636 men age 18 to 55 years from GENESIS-PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond-Premature Acute Coronary SYndrome), a prospective observational cohort study, who were hospitalized for ACS between January 2009 and April 2013. Gender-related characteristics (e.g., social roles) were assessed using a self-administered questionnaire, and a composite measure of gender was derived. Outcomes included recurrent ACS and MACE over 12 months. RESULTS: Feminine roles and personality traits were associated with higher rates of recurrent ACS and MACE compared with masculine characteristics. This difference persisted for recurrent ACS, after multivariable adjustment (hazard ratio from score 0 to 100: 4.50; 95% confidence interval: 1.05 to 19.27), and was a nonstatistically significant trend for MACE (hazard ratio: 1.54; 95% confidence interval: 0.90 to 2.66). A possible explanation is increased anxiety, the only condition that was more prevalent in patients with feminine characteristics and that rendered the association between gender and recurrent ACS nonstatistically significant (hazard ratio: 3.56; 95% confidence interval: 0.81 to 15.61). Female sex was not associated with outcomes post-ACS. CONCLUSIONS: Younger adults with ACS with feminine gender are at an increased risk of recurrent ACS over 12 months, independent of female sex.
“Our study suggests that adults with role and personality traits traditionally ascribed to women have an increased risk of recurrence of premature acute coronary syndrome (ACS) or major adverse cardiac events within 12 months following their first incident, regardless of their biological sex. It is therefore important, as researchers, to consider gender in addition to biological sex when we analyze the differences between men and women for various diseases.”
Pelletier et al. (Fri,) conducted a cohort in premature acute coronary syndrome (n=909). Feminine gender characteristics vs. Masculine characteristics was evaluated on recurrent ACS (HR 4.50, 95% CI 1.05-19.27). Feminine gender characteristics were associated with a higher risk of recurrent ACS over 12 months compared with masculine characteristics (HR 4.50; 95% CI 1.05-19.27), independent of female sex.