April 1, 2004Open Access
View Full PaperSex, age, and clinical presentation of acute coronary syndromes
Key Result
Among patients <65 years with acute coronary syndromes, women were less likely than men to present with ST elevation (OR 0.62; 95% CI 0.53-0.71) and more likely to have unstable angina.
Study Design
Type
Observational (n=10,253)
Multicenter
Yes
Structured PICO
Do sex differences in the clinical presentation of acute coronary syndromes vary by age?
P
Population
10,253 patients with a discharge diagnosis of acute coronary syndromes from the Euro Heart Survey, analyzed to investigate sex and age differences in clinical presentation.
E
Exposure
Female sex (observational comparison)
C
Comparator
Male sex
O
Outcome
Clinical presentation (ST elevation, Q-wave myocardial infarction, unstable angina) and extent of atherosclerosis on angiography
Younger women with acute coronary syndromes are less likely to present with ST elevation and more likely to be diagnosed with unstable angina compared to men of the same age, suggesting a different pathophysiology in younger women.
Main Result
Odds Ratio: 0.62 (95% CI 0.53–0.71)
Abstract
AIM: To investigate sex differences in clinical presentation in younger and older patients hospitalised with a wide spectrum of acute coronary syndromes (ACS). METHODS AND RESULTS: We analysed 10253 patients with a discharge diagnosis of ACS in the Euro Heart Survey of patients with Acute Coronary Syndromes. There were 1010 women and 3709 men or =65 years there was no significant sex difference. Women or =65 years. CONCLUSION: In younger patients with ACS, women were less likely than men to present with ST elevation and more likely to be discharged with a diagnosis of unstable angina. In older patients there were no differences in clinical presentation. Both older and younger women had less extensive atherosclerosis. The findings suggest a different pathophysiology of ACS in younger, but not older, women.