Sex and Age Differences in Patients With Unstable Angina Pectoris: A Single-Center Retrospective Study
Min Xu1, Hong-Wei Li2, Hui Chen1
1Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Insights
Sex and age significantly influence coronary heart disease risk factors and outcomes. Women experienced higher cholesterol and lower adverse events, while elderly women had more comorbidities than men.
Area of Science:
- Cardiology
- Public Health
- Geriatrics
Background:
- Sex and age are known to influence cardiovascular disease (CVD) development and outcomes.
- However, detailed understanding of how these factors impact coronary heart disease (CHD) risk factors, treatment, and prognosis remains limited.
Purpose of the Study:
- To investigate the differences in cardiovascular risk factors, treatment strategies, and in-hospital prognosis among patients with unstable angina pectoris, stratified by sex and age groups.
- To elucidate the specific impact of sex and age on the clinical presentation and outcomes of CHD.
Main Methods:
- A single-center retrospective cohort study included 5,908 patients with unstable angina pectoris (January 2013 - June 2018).
- Patients were stratified into four age groups: <55, 55-64, 65-74, and ≥75 years.
- Analysis focused on comparing cardiovascular risk factors, treatment patterns, and in-hospital major adverse cardiovascular events (MACE) between sexes and age strata.
Main Results:
- Women (2,198) were older (mean age 67 vs. 62 years) and had higher total cholesterol, LDL-C, and HDL-C levels compared to men.
- Hypertension, diabetes, and chronic kidney disease were more prevalent in women aged ≥65 years.
- Men had higher rates of smoking and family history of CHD, while younger individuals (<65 years) of both sexes exhibited higher BMI and fasting glucose.
Conclusions:
- Women exhibited distinct cardiovascular risk factor profiles, including higher cholesterol, and were less likely to receive revascularization therapy.
- Elderly women presented with a higher burden of comorbidities like hypertension, diabetes, and chronic kidney disease.
- While women had lower in-hospital major adverse cardiovascular events, in-hospital cardiac mortality showed no significant sex difference.
Background:
Sex and age may affect the pathogenesis of coronary heart disease, such as cardiovascular risk factors, treatment and prognosis, but this information is not well known.
Methods:
This was a single-center retrospective cohort study. Patients with unstable angina pectoris between January 2013 and June 2018 were included and stratified into 4 age groups (<55, 55-64, 65-74 and ≥75 years). The cardiovascular risk factors profile, treatment and in-hospital prognosis differences by sex and age were explored.
Results:
This study included 5,908 patients (2,198 women). The women were older than the men (mean age 67 vs. 62 years). Approximately 2 of 3 patients had ≥3 cardiovascular risk factors. Men were more likely to be smokers, and women had a higher level of total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Hypertension, diabetes and chronic kidney disease were more frequent in women ≥ 65 years old than in similarly aged men. Men and women less than 65 years of age had more frequent family history of coronary heart disease, higher body mass index, higher fasting plasma glucose, and higher lipid levels, especially for patients <55 years of age. More women tended to receive medical therapy than men (51.6% vs. 42.8%, P < 0.01). The overall incidence of in-hospital major adverse cardiovascular events was higher in men than in women (4.1% vs. 2.6%, P < 0.05), whereas there was no sex difference in the in-hospital cardiac mortality (0.2% vs. 0.2%, P > 0.05).
Conclusions:
Women had higher cholesterol levels, and were less likely to undergo revascularization therapy than similarly aged men, and elderly women had a higher prevalence of hypertension, diabetes, and chronic kidney disease than elderly men. In-hospital major adverse cardiovascular events were lower in women than in men; however, there was no sex difference in the in-hospital cardiac mortality.
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