Gender-related differences in clinical course, therapeutic approach and prognosis in patients with non-ST segment...

There is accumulated evidence that clinical course and prognosis after myocardial infarction (MI) may differ between genders.

To compare epidemiology, the clinical course, therapeutic approach and prognosis in men and women with non-ST segment elevation MI (NSTEMI).

We analysed a total of 1219 consecutive patients with NSTEMI (43% women) treated between June 01, 2005 and May 31, 2006 in a hospital covering in a district with 1,300,000 inhabitants. The data were obtained from the Polish Registry of Acute Coronary Syndromes (PL-ACS).

Women in the study group were on average 6 years older than men (72.6 ± 10.3 vs 66.7 ± 11.4 years; p < 0.0001). The incidence of arterial hypertension (83.4% vs 73.45%; p < 0.0001), diabetes mellitus (30.2% vs 20.1%; p < 0.0001) and obesity (17.9% vs 13.1%; p < 0.020) was higher in women, while cigarette smoking was more common in men (7.4% vs 32.9%; p < 0.0001). Clinical presentation was similar in both genders. Coronary angiography was performed in 360 patients, more frequently in men (32.8% vs 25.2%; p < 0.05). Less women than men underwent percutaneous coronary angioplasty (18.9% vs 12.6%; p < 0.0033). In-hospital, 30-day and 6-month mortality was similar in both genders (5.3% vs 4.9%; 6.9% vs 7.3%; and 13.2% vs 13.1%, respectively). In a multivariate analysis, female gender did not influence the prognosis.

Although women with NSTEMI had worse baseline characteristic and less frequently underwent revascularisation, their outcomes were comparable with those in men.