Female sex was not associated with an increased risk of the primary composite outcome at 1 year compared to male sex (OR 1.16; 95% CI 0.65-2.06; P=0.59).
Cohort (n=1,000)
No
Does female sex affect the composite outcome of readmission, ACS, revascularization, and death in patients with acute chest pain evaluated in a chest pain unit compared to male sex?
Evaluation of acute chest pain through a chest pain unit results in similar short- and intermediate-term outcomes for men and women, despite women having less significant CAD and undergoing fewer invasive procedures.
Effect estimate: OR 1.16 (95% CI 0.65-2.06)
p-value: p=0.59
BACKGROUND: Although sex disparities between patients with acute myocardial infarction are well known, the data regarding sex differences among symptomatic patients with acute chest pain (ACP) are limited. METHODS: We retrospectively evaluated the records of 1000 consecutive patients with ACP and hospitalized in a tertiary medical center chest pain unit (CPU). Patients were divided according to sex. The primary outcome was defined as a composite end point of readmission because of chest pain, incidence of acute coronary syndrome, revascularization, and death at 90 days and 1 year. RESULTS: Overall, 673 men and 327 women were included in the current analysis. There was no difference in regard to sex for patients who underwent noninvasive evaluation, (87.8 vs. 87.3%, P = 0.85, for female vs. male, respectively). Among patients who underwent coronary computed tomography angiography, women were less likely to have significant coronary artery disease (CAD) (4.2 vs. 11.3%, P = 0.005). Similarly, women had fewer significant findings (4.4 vs. 7.6%, P = 0.007) on myocardial perfusion imaging. Consequently, fewer women underwent angiography (8 vs. 14%, P = 0.006) and revascularization (2.8 vs. 7.3%, P = 0.004). During follow-up, sex was not associated with the development of the primary composite outcome odds ratio (OR) 0.91, 95% confidence interval (CI) 0.39-2.09, P -value = 0.82 and OR 1.16, 95% CI 0.65-2.06, P -value = 0.59 for 90-day and 1-year follow-up, respectively. CONCLUSION: Evaluation of patients through a CPU enables comparable noninvasive evaluation, appropriate utilization of invasive assessment with similar outcomes during the short and intermediate follow-up period regardless of patients' sex.
Arzuan et al. (Mon,) conducted a cohort in Acute chest pain (n=1,000). Female sex vs. Male sex was evaluated on Composite of readmission because of chest pain, incidence of acute coronary syndrome, revascularization, and death at 90 days and 1 year (OR 1.16, 95% CI 0.65-2.06, p=0.59). Female sex was not associated with an increased risk of the primary composite outcome at 1 year compared to male sex (OR 1.16; 95% CI 0.65-2.06; P=0.59).