Sex-Based Risk Evaluation in Acute Coronary Events-A Study Conducted on an Eastern-European Population
Svetlana Mosteoru1,2, Nilima Rajpal Kundnani2,3, Abhinav Sharma1,3
1Ph.D. School Department, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Insights
Women with coronary events had a worse risk factor profile, despite no significant sex differences in comorbidities. Sex-specific models are needed for better cardiovascular disease risk factor control in women.
Area of Science:
- Cardiology
- Public Health
- Sex Differences in Medicine
Background:
- Cardiovascular diseases cause 32% of female deaths, with distinct risk factors compared to men.
- Understanding sex-related differences in cardiovascular risk is crucial for targeted prevention and treatment.
Purpose of the Study:
- To compare sex-specific risk factors and comorbidities in patients with very high cardiovascular risk.
- To identify potential disparities in cardiovascular disease management between men and women.
Main Methods:
- Prospective enrollment of 299 adult patients hospitalized for myocardial infarction or unstable angina.
- Clinical and biochemical evaluations conducted 6 months to 2 years post-event.
- Assessment of patient characteristics, comorbidities, and cardiovascular risk factors.
Main Results:
- Women were older and more obese than men, with no significant differences in hypertension, diabetes, dyslipidemia, or chronic kidney disease prevalence.
- Women were significantly less likely to be current or former smokers.
- Multivariable analysis indicated sex was not an independent predictor for myocardial infarction, PCI, or CABG after adjusting for key factors.
Conclusions:
- Women with prior coronary events exhibited a less favorable risk factor profile compared to men.
- No significant sex-based differences were found in the overall prevalence of comorbidities.
- Future cardiovascular risk management strategies should incorporate sex-specific prediction models for improved outcomes.
Abstract:
Background and Objectives: Cardiovascular (CV) diseases account for about 32% of deaths in women, with differing risk factors between women and men. Our study aimed to compare sex-related risk factors and comorbidities in patients at very high CV risk. Materials and Methods: We consecutively enrolled adult patients hospitalized for myocardial infarction or unstable angina at a tertiary referral center in western Romania between October 2016 and June 2017. A total of 299 adults underwent clinical and biochemical evaluations between 6 months and 2 years after their coronary event. We assessed patients' specific characteristics, comorbidities, and risk factors. Results: Women made up only a quarter of the survey participants (74 women, 24.7%) and were generally older (63.32 ± 9.3 vs. 60.51 ± 9.3, p = 0.02) and more obese (31.20 ± 6.0 vs. 29.48 ± 4.9, p = 0.02). There were no significant differences in the prevalence of hypertension, diabetes, dyslipidemia, chronic kidney disease, or peripheral artery disease, though women had slightly higher rates for most comorbidities. Regarding smoking habits, both groups had high percentages of current and former smokers, with women being significantly less likely to smoke (20.9% vs. 44.6%, p = 0.003). Multivariable logistic regression adjusting for age, BMI, smoking status, diabetes, and eGFR revealed that sex was not a statistically significant independent predictor for myocardial infarction, PCI, or CABG. Conclusions: We observed that women with previous coronary events had a worse risk factor profile, while there were no significant sex differences in overall comorbidities. Risk factor control should be based on sex-specific prediction models.
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