Preview

Cardiovascular Therapy and Prevention

Advanced search

Gender-specific prognosis in acute coronary syndrome

Abstract

Aim. To study the gender-specific perspectives of in-hospital outcome prognosis in acute coronary syndrome (ACS) patients. Material and methods. In total, 1035 consecutive patients with acute myocardial ischemia were included in the study. The role of clinical and laboratory parameters in ACS prognosis was assessed by binary logistic regression. Results. Under age of 65 years, ACS in males resulted in Q-myocardial infarction (MI) more often (23.4%) than in females (9.7%; p<0.001). In patients over 65, ACS structure was similar for both genders. Women were hospitalized with cardiovascular pathology or diabetes mellitus in anamnesis more often; females under 65 used anti-ischemic medications in arterial hypertension (AH) and coronary heart disease (CHD) therapy more actively. In univariate analysis of baseline parameters, predictors of fatal ACS outcome might be divided into three groups: risk factors (RF) with gender-independent outcome impact; RF with varying impact; RF with gender-specific impact. In a multivariate model, fatal outcome probability assessment was more effective in males than in females: explained dispersion was 72.4% and 48.5%, area under curve – 0.99 and 0.93, respectively. Conclusion. Gender-specific study on RF and their predictive value is optimal for predicting in-hospital outcomes of ACS.

About the Authors

R. T. Saygitov
Russian Research Institute of Gerontology, Russian Federal Agency of Health and Social Development
Russian Federation


M. G. Glezer
City Clinical Hospital No. 59. Moscow
Russian Federation


D. P. Sementsov
City Clinical Hospital No. 59. Moscow
Russian Federation


N. A. Malygina
Russian Research Institute of Gerontology, Russian Federal Agency of Health and Social Development
Russian Federation


References

1. Глезер М.Г., Сайгитов Р.Т., Семенцов Д.П. и др. Острый коронарный синдром у пожилых: прогноз госпитальной смертности. Клин геронт 2005; 11(1): 13-20.

2. Boersma E, Pieper KS, Steyerberg EW, et al. Predictors of outcome in patients with acute coronary syndromes without persistent ST-segment elevation: results from an international trial of 9461 patients. Circulation 2000; 101: 2557-67.

3. Brunner EJ, Marmot MG, White IR, et al. Gender and employment grade differences in blood cholesterol, apolipoproteins and haemostatic factors in the Whitehall II study. Atherosclerosis 1993; 102(2): 195-207.

4. Fiebach NH, Viscoli CM, Horwitz R.I. Differences between women and men in survival after myocardial infarction. Biology or methodology? JAMA 1990; 263(8): 1092-6.

5. Granger CB, Goldberg RJ, Dabbous OM, et al. Predictors of hospital mortality in the Global Registry of Acute Coronary Events. Arch Int Med 2003; 163: 2345-53.

6. Guralnik JM, Eisenstaedt RS, Ferrucci L, et al. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood 2004; 104(8): 2263- 8.

7. Hargrove GM, Junco A, Wong NC. Hormonal regulation of apolipoprotein AI J Mol Endocrinol 1999; 22(2): 103-11.

8. Hasdai D, Behar S, Wallentin L, et al. A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes. Eur Heart J 2002; 23(15): 1190-201.

9. Haverkate F, Thompson SG, Duckert F. Haemostasis factors in angina pectoris; relation to gender, age and acute-phase reaction. Results of the ECAT Angina Pectoris Study Group. Thromb Haemost 1995; 73(4): 561-7.

10. Hochman JS, McCabe CH, Stone PH, et al. Outcome and profile of women and men presenting with acute coronary syndromes: a report from TIMI IIIB. JACC 1997; 30: 141-8.

11. Johansson S, Bergstrand R, Schlossman D, et al. Sex differences in cardioangiographic findings after myocardial infarction. Eur Heart J 1984; 5: 374-81.

12. Marchioli R, Avanzini F, Barzi F, et al. Assessment of absolute risk of death after myocardial infarction by use of multiple-risk-factor assessment equations. GISSI-Prevention mortality risk chart. Eur Heart J 2001; 22: 2085-103.

13. Newby LK, Bhapkar MV, White HD, et al. Predictors of 90-day outcome in patients stabilized after acute coronary syndromes. Eur Heart J 2003; 24: 172-81.

14. Pocock S, McCormack V, Gueyffier F, et al. A score for predicting risk of death from cardiovascular disease in adults with raised blood pressure, based on individual patient data from randomized controlled trial. BMJ 2001; 323: 75-81.

15. Rosengren A, Wallentin L, Gitt A, et al. Sex, age, and clinical presentation of acute coronary syndromes. Eur Heart J 2004; 25(8): 663-70.

16. Stegnar M, Pentek M. Fibrinolytic response to venous occlusion in healthy subjects: relationship to age, gender, body weight, blood lipids and insulin. Thromb Res 1993; 69: 81-92.

17. Zindrou D, Taylor KM, Bagger JP. Admission plasma glucose: an independent risk factor in nondiabetic women after coronary artery bypass grafting. Diabetes Care 2001; 24(9): 1634-9.


Review

For citations:


Saygitov R.T., Glezer M.G., Sementsov D.P., Malygina N.A. Gender-specific prognosis in acute coronary syndrome. Cardiovascular Therapy and Prevention. 2006;5(1):63-70. (In Russ.)

Views: 590


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)