Genderspecific risk factors and outcomes of ischemic heart disease

Abstract

Objective. To study the relationship of gender with the risk factors for coronary artery disease and adverse long-term outcomes in patients with acute coronary syndrome without ST segment elevation (nonST-ACS). Results. Women were older than men, significantly more likely had arterial hypertension and diabetes, but six times less smoked. Coronary artery stenosis >50% in history occurred in men more often than women: 24.2% vs. 11.7%. The median value of the left ventricular ejection fraction in men was significantly lower than in women (56 (49; 63) vs. 60 (50; 64.7), p=0.028). Men were significantly more likely to have a low risk (39.6% versus 24.5%, p=0.0027), and women had a high risk on the GRACE scale (35% versus 21.6%, p=0.0053). Women significantly (p<0.001) were less likely to undergo coronary angiography, while coronary artery stenosis was more frequent (p<0.001) in men than in women. The median scores on the Syntax score were significantly (p<0.001) lower in women - 9.5 (6; 16.5) compared to the same in men - 14 (7; 22). PCI was performed significantly more often in men (p<0.001). Differences in the incidence of adverse cardiovascular events during the five-year follow-up period after discharge after index nonST-ACS for men and women have not been identified. Conclusion. Women with nonST-ACS have more cardiovascular risk factors, in this case, the incidence of adverse cardiovascular events is the same as men with less pronounced coronary lesions, so need to use more actively invasive strategy of women during the index hospitalization.