Sex Differences in Heart Failure Following Acute Coronary Syndromes

Journal
JACC: Advances
Date Issued
2023-05
Author(s)
Cenko, Edina
Manfrini, Olivia
Yoon, Jinsung
van der Schaar, Mihaela
Bergami, Maria
Vasiljevic, Zorana
Mendieta, Guiomar
Stankovic, Goran
Miličić, Davor
Badimon, Lina
Bugiardini, Raffaele
DOI
10.1016/j.jacadv.2023.100294
Abstract
BACKGROUND There have been conflicting reports regarding outcomes in women presenting with acute coronary syndrome (ACS).OBJECTIVES The objective of the study was to examine sex-specific differences in 30-day mortality in patients with ACS and acute heart failure (HF) at the time of presentation.METHODS This was a retrospective study of patients included in the International Survey of Acute Coronary Syndromes (ISACS Archives-NCT04008173). Acute HF was defined as Killip classes $2. Participants were stratified according to ACSpresentation: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTE-ACS). Differences in 30-day mortality and acute HF presentation at admission between sexes were examined using inverse propensity weighting based on the propensity score. Estimates were compared by test of interaction on the log scale. RESULTS A total of 87,812 patients were included, of whom 30,922 (35.2%) were women. Mortality was higher in women compared with men in those presenting with STEMI (risk ratio (RR): 1.65; 95% CI: 1.56-1.73) and NSTE-ACS (RR:1.18; 95% CI: 1.09-1.28; P interaction < 0.001). Acute HF was more common in women when compared to men with STEMI(RR: 1.24; 95% CI: 1.20-1.29) but not in those with NSTE-ACS (RR: 1.02; 95% CI: 0.97-1.08) (P interaction < 0.001). The presence of acute HF increased the risk of mortality for both sexes (odds ratio: 6.60; 95% CI: 6.25-6.98).CONCLUSIONS In patients presenting with ACS, mortality is higher in women. The presence of acute HF at hospital presentation increases the risk of mortality in both sexes. Women with STEMI are more likely to present with acute HFand this may, in part, explain sex differences in mortality. These findings may be helpful to improve sex-specific personalized risk stratification. (JACC Adv 2023;-:100294) © 2023 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open-access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
(14) (PDF) Sex Differences in Heart Failure Following Acute Coronary Syndromes. Available from: https://www.researchgate.net/publication/370306869_Sex_Differences_in_Heart_Failure_Following_Acute_Coronary_Syndromes [accessed Jun 23, 2023].
Subjects

acute heart failure

outcomes

sex differences

File(s)
Loading...
Thumbnail Image
Name

Sex Differences in Heart Failure Following Acute Coronary Syndromes.pdf

Size

1.04 MB

Format

Adobe PDF

Checksum

(MD5):5425846ee70a8ac9e5b50e77222d12b6