Why the study?
Sex-specific differences in acute coronary syndrome management and mortality outcomes remain incompletely understood, particularly how age and treatment disparities influence female survival advantage.
Does female sex compared to male sex affect all-cause mortality in patients with acute coronary syndrome?
Population
184,616 ACS patients in Hungary from 2014 to 2024
Comparison
Female sex vs male sex
Design
Nationwide registry observational study with propensity score matching
Follow-up
Median 3.1 years (IQR 0.8-6.2 years)
Key result
After propensity score matching, female patients with acute coronary syndrome had a 10.3 percentage-point lower all-cause mortality compared to males (p < 0.001).
Authors
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Female survival advantage in ACS after matching should not change practice; leaves open confirmation in prospective studies.
Observational (n=184,616)
Yes
Does female sex compared to male sex affect all-cause mortality in patients with acute coronary syndrome?
Absolute Risk Reduction: 10.3
Absolute Event Rate: 25.7% vs 19.8%
Absolute Risk Reduction: 10.3%
p-value: p=<0.001
Despite presenting with more complex clinical profiles and receiving less intensive treatment, women with acute coronary syndrome demonstrate a significant survival advantage over men after adjusting for baseline differences and treatment gaps.
Sári et al. (2026) conducted an observational in Acute coronary syndrome (n=184,616). Female sex vs. Male sex was evaluated on All-cause mortality (10.3 percentage-point lower, p=<0.001). After propensity score matching, female patients with acute coronary syndrome had a 10.3 percentage-point lower all-cause mortality compared to males (p < 0.001).