Contemporary sex differences among patients with acute coronary syndrome treated by emergency percutaneous coronary intervention

Wada, Hideki; Ogita, Manabu; Miyauchi, Katsumi; Tsuboi, Sadao; Konishi, Hirokazu; Shitara, Jun; Kunimoto, Mitsuhiro; Sonoda, Taketo; Iso, Takashi; Ebina, Hideki; Aoki, Eriko; Kitamura, K.; Tamura, Hiroshi; Suwa, Satoru; Daida, Hiroyuki

doi:10.1007/s12928-016-0416-y

Cited by 5 publications

(7 citation statements)

References 17 publications

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“…These tendencies were found more often for Black women than others, especially when considering younger patients who were lacking social support, community resources, cognitive deficiencies, and physician follow-up. In Japan, Wada et al reported that female gender was not an independent predictor for the incidence of major adverse cardiac events after adjusting for age and other variables among patients with ACS [ 20 ]. The limited diversity of races or ethnicity in Japan could have attenuated the differences in outcomes between women and men after ACS.…”

Section: Discussionmentioning

confidence: 99%

Gender difference in heart failure with preserved ejection fraction: clinical profiles, examinations, and prognosis

Sakai¹,

Motoki

Suzuki

et al. 2022

Heart Vessels

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Heart failure with preserved ejection fraction (HFpEF) has currently become a major concern in the aging society owing to its substantial and growing prevalence. Recent investigations regarding sacubitril/valsartan have suggested that there is a gender difference in the efficacy of the medication in HFpEF cohort. However, information of gender difference in clinical profiles, examination, and prognosis have not been well investigated. The present study aimed to evaluate the differences in baseline characteristics and outcomes between women and men in a Japanese HFpEF cohort. We analyzed the data from our prospective, observational, and multicenter cohort study. Overall, 1036 consecutive patients hospitalized for acute decompensated heart failure were enrolled. We defined patients with an ejection fraction (EF) of ≥ 50% as HFpEF. Patients with severe valvular disease were excluded; the remaining 379 patients (women: n = 201, men: n = 178) were assessed. Women were older than men [median: 85 (79–89) years vs. 83 (75–87) years, p = 0.013]. Diabetes mellitus, hyperuricemia, and coronary artery disease were more prevalent in men than in women (34.8% vs. 23.9%, p = 0.019, 23.6% vs. 11.4%, p = 0.002, and 23.0% vs. 11.9%, p = 0.005, respectively). EF was not significantly different between women and men. The cumulative incidence of cardiovascular death or hospitalization for congestive heart failure (CHF) was significantly lower in women than in men (log-rank p = 0.040). Women with HFpEF were older and less often exhibited an ischemic etiology; further, they were associated with a lower risk for cardiovascular death or hospitalization for CHF compared with men in the Japanese population.

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Section: Discussionmentioning

confidence: 99%

Gender difference in heart failure with preserved ejection fraction: clinical profiles, examinations, and prognosis

Sakai¹,

Motoki

Suzuki

et al. 2022

Heart Vessels

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“…Multivariate analysis showed that female sex was not an independent risk factor in achieving the primary endpoint. However, many studies have reported a worse long-term prognosis for women after AMI ( 18 ) and a higher 30-day mortality in women than men ( 19 – 21 ). According to the VIRGO analysis (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), women are more likely than men to attribute symptoms of myocardial infarction to stress/anxiety ( 22 ), resulting in delayed initial medical contact and diagnosis ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Does gender affect the outcomes of patients in program of managed care for acute myocardial infarction

Wilkosz

Wita²,

Wybraniec³

et al. 2021

J Rehabil Med

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Background There is increasing evidence that cardiac rehabilitation and regular follow-ups are associated with reduced mortality and morbidity. A programme of Managed Care for Patients with Acute Myocardial Infarction was developed in Poland (MC-AMI; in Polish, KOS-zawał), based on current scientific evidence. However, there is a lack of data on possible improvement in long-term prognosis among women after acute myocardial infarction. Aims To compare the male and female population who participated in MC-AMI, regarding major cardiovascular events, defined as a composite of death, recurrent myocardial infarction, and hospitalization for heart failure, in a 1-year follow-up. Methods A prospective research study from a single cardiology care centre. The study compared 2 groups: women and men who agreed to participate in the MC-AMI programme. Results A total of 529 patients were included in the study (167 women and 362 men). In the 12-month follow-up, the difference in major cardiovascular events events was not statistically significant for women and men, respectively (11.38% women vs 11.33% men; p = 0.98). Cox multivariate regression analysis of the surveyed population showed that coronary heart disease, diabetes mellitus type II, and previous percutaneous coronary intervention were significantly correlated with the primary endpoint. Conclusion Women participating in the MC-AMI programme did not have a worse prognosis regarding major cardiovascular events, compared with men in a 12-month follow-up. Given the benefits of the MCAMI programme, the proportion of women participating in the programme should be increased. LAY ABSTRACT Despite the development of new treatment techniques, myocardial infarction remains one of the leading causes of death in Europe. Women account for 48% of patients with myocardial infarction. Due to clinical, economic, demographic and sociological conditions, the long-term prognosis for women after myocardial infarction is worse than for men. A national programme of managed care after myocardial infarction has been introduced in 2019 year in Poland (MC-AMI; in Polish, KOS-zawał). The programme comprises 4 stages: hospitalization and treatment of the acute phase of myocardial infarction; early cardiological rehabilitation; regular follow-up at in-patient clinic; and evaluation of indications for advanced methods of treatment of post-infarction complications. Implementation of this programme in Poland has resulted in a comparable long-term prognosis being achieved for the male and female population. Widespread use of the MC-AMI programme is a promising option to equalize the prognosis for both sexes after a heart attack.

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“…This has led to difficulty interpreting the results of the literature, as when preoperative comorbidities and intraoperative approach are not controlled confounding variables prevent accurate analysis of the data. The majority of the studies noted in this review, as well and numerous other publications in the literature, have demonstrated that inferior outcomes experienced by females diminish after adjusting for preoperative risk and controlling for surgical approach [14][15][16]18,19,22,24,25,30,32,33]. This process reduces the number of confounding variables and most studies have not determined that female sex is an independent predictor of adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Included were retrospective analysis, prospective observational studies, trial, and systematic reviews. All data included were collected from 2000 to 2018 [11,[15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Average rates of mortality and morbidity were compiled and averaged based on exact and approximated values from each study.…”

Section: Overview Of Percutaneous Coronary Intervention Trials Compar...mentioning

confidence: 99%

Review of the differences in outcomes between males and females after revascularization

EL‐Andari

Bozso

Kang

et al. 2021

Current Opinion in Cardiology

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Purpose of reviewThis review aims to compare outcomes of males and females undergoing coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), off-pump CABG (OPCAB), minimally invasive direct CABG (MIDCAB), and robotic total endoscopic CABG (TECAB). Recent findingsFemales demonstrated increased rates of morbidity and mortality post PCI and CABG. In studies that performed risk adjustments, these differences were reduced. Although inferior outcomes were observed for females in some measures, generally outcomes between males and females were comparable post OPCAB, MIDCAB, and TECAB SummaryPrevious literature has demonstrated that females undergoing coronary revascularization experience inferior postoperative outcomes when compared to their male counterparts. The discrepancies between males and females narrow, but do not disappear when preoperative risks are accounted for and when considering minimally invasive approaches such as MIDCAB, OPCAB, and TECAB. Minimally invasive cardiac surgery has demonstrated numerous benefits with reduced morbidity, mortality, and shorter recovery times. In patients with increased comorbidities, minimally invasive approaches confer a greater advantage. As females often fall within this category, it is paramount that the diagnosis and referral process be optimized to account for preoperative differences to provide the most beneficial approach if the disparity between the sexes is to be addressed.

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Contemporary sex differences among patients with acute coronary syndrome treated by emergency percutaneous coronary intervention

Cited by 5 publications

References 17 publications

Gender difference in heart failure with preserved ejection fraction: clinical profiles, examinations, and prognosis

Gender difference in heart failure with preserved ejection fraction: clinical profiles, examinations, and prognosis

Does gender affect the outcomes of patients in program of managed care for acute myocardial infarction

Review of the differences in outcomes between males and females after revascularization

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