Sex differences in characteristics and outcome in acute coronary syndrome patients in the Netherlands

Haaf, Monique E. ten; Bax, Matthijs; Berg, Jürrien M. ten; Brouwer, Jan; Hof, Arnoud Wj van’t; Schaaf, René J. van der; Stella, Pieter R.; Gin, R. Melvyn Tjon Joe; Tonino, Pim A.L.; Vries, Arie G. de; Zijlstra, Felix; Boersma, Eric; Appelman, Yolande

doi:10.1007/s12471-019-1271-0

Cited by 33 publications

(32 citation statements)

References 31 publications

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“…This concurs with a previous study with a similar age distribution. 34 Our study showed that 53.2% of the patients had diastolic dysfunction, which is also like other studies. 35 , 36 Valvular disease was more prevalent in the non-ischemic group, as reported previously.…”

Section: Discussionsupporting

confidence: 91%

Thyroid Dysfunction in Patients Admitted in Cardiac Care Unit: Prevalence, Characteristic and Hospitalization Outcomes

Alqahtani

Alakkas

Althobaiti

et al. 2021

IJGM

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Introduction Cardiovascular disease is one of the main causes of hospital admission and mortality, and thyroid dysfunction increases the risk of developing acute or exacerbation of chronic cardiac conditions. The aim of this study is to investigate the prevalence of thyroid hormone abnormality among patients in the cardiac care unit (CCU) patients and its relation to admission diagnosis, clinical, biochemical data, and hospital-related outcomes. Methods We conducted a retrospective cohort observational that included adult patients who were admitted to the CCU. We excluded those with known thyroid dysfunction and those who received amiodarone or IV contrast. Results A total of 374 patients with a mean age of 62.7+14.7 years old were included. Ischemic changes were observed in 70.6% of the patients based on the admission diagnosis. In comparison to the non-ischemic group, the ischemic group was more likely to be male (P=0.010), to be active/former smokers (P=0.011), to have diabetes (P=0.009), to have diastolic dysfunction (P=<0.001), to have undergone thrombolysis (P=<0.001), and to have been referred to a tertiary center (P=<0.001). Euthyroidism was observed in 57.8% of the patients based on the thyroid function test at admission. Compared to patients with thyroid dysfunction, those with Euthyroidism were more likely to be active/former smokers (P=0.002), to have lower heart rates (P=0.018), to not have chronic kidney disease (P=0.016), to not have heart failure (P=0.006), to have lower thyroid-stimulating hormone (TSH) levels (P=<0.001), and to have lower tricuspid regurgitation (P=0.042). Conclusion Thyroid dysfunction is common among patients admitted to the CCU. Non-significant positive correlations between TSH and hospitalization length, tertiary center referral, 30-day readmission, and in-hospital mortality when adjusting for potential confounders.

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Section: Discussionsupporting

confidence: 91%

Thyroid Dysfunction in Patients Admitted in Cardiac Care Unit: Prevalence, Characteristic and Hospitalization Outcomes

Alqahtani

Alakkas

Althobaiti

et al. 2021

IJGM

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“…Khan et al have found a higher proportion of family history of premature coronary artery diseases among females than males in a study done on young patients [21]. However, a study done in Netherland has revealed a low prevalence of family history of coronary artery disease in females (40.2%) than the male (42.1%) with ACS [22]. There was no signi cant difference in family histories of IHD, diabetes mellitus, stroke or dyslipidaemia in our population.…”

Section: Discussioncontrasting

confidence: 49%

The Influence of Sex on Navigating Acute Coronary Syndrome: A Hospital-Based Cohort Study in South Asia

Ralapanawa

Karunathilake

Bandara

et al. 2021

Preprint

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BackgroundThe cardiovascular risk profile and adverse events following acute coronary syndrome (ACS) differ between the Sex, indicating the importance of studying the sex differences in factors associated with ACS.MethodsA cross-sectional descriptive study was performed among ACS patients presented to Teaching Hospital Peradeniya. An interviewer-administered prevalidated questionnaire was used to collect data, and analysis was done. ResultsA total of 789 patients were included, consisting of 40.4% females. The mean age of females (62.17±11.06) was higher than males (59.80±11.24) (p=0.004), and in females, the mean age for unstable angina (60.5±10.5) was lower than NSTEMI (63.8±12.5) (p=0.022) and STEMI (64.0±9.2) (p=0.026). The male-female composition for unstable angina (46.3% vs 53.7%) and STEMI (75.8% vs 24.2%) showed varied proportions. The mean BMI (24.95±4.40 kg m-3 vs 23.77±3.88 kg m-3) (p=0.008) and obesity (21.6% vs 13.8%) (p=0.048) was higher in females. Overweight (9.4% vs 8.8%) (p=0.048) and the waist-hip ratio (0.98±0.07 vs 0.94±0.10) (p=0.006) was higher in males. Family history of hypertension was higher in females (24.1% vs 17.0%) (p=0.014). Most of the females were co-morbid with diabetes (37.9%) (p=0.008), hypertension (59.8%) (p<0.001) and dyslipidaemia (40.3%) (p<0.001) than males. The prevalence of smoking and alcohol intake was significantly higher in males (p<0.001). The predominant symptom was chest pain (93.4%), regardless of Sex. Right chest pain was primarily present in females (8.0% vs 3.6%) (p=048), and radiation of pain to the right arm mainly occurred in males (18.2% vs 7.5%) (p=0.007). Vomiting and dyspnoea was higher in females (47.7% vs 38.4%, p=0.049 and 53.1% vs 43.2%, p=0.039). The delay in presentation to the hospital was more in females (6:04±6:02) than males (3:55±4:22) with STEMI. The commonest reason for the delay was not suspecting an ACS, and a three-wheeler was the primary mode of transport in both sexes without any sex difference. Only 7.0% was delayed due to the unavailability of a transport facility.ConclusionFemale and male patients with ACS show differences in the age of onset, the spectrum of ACS, comorbidities, anthropometric measurements, risk factors like smoking and alcohol intake, clinical presentation aspects and delay in presentation to the hospital.

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“…Furthermore, an increased inflammatory response was associated with no-reflow and higher mortality post-STEMI. Another study showed that women younger than 71 years have a higher one-year mortality compared to the older women, whereas older women had a lower mortality compared to older men 21 . Our study is of additive value, since it provides a comprehensive overview of the leukocyte profiles directly after MI and their potential associations with outcome.…”

Section: Discussionmentioning

confidence: 98%

Sex differences in leukocyte profile in ST-elevation myocardial infarction patients

Blokland

Groot

Hendriks

et al. 2020

Sci Rep

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Background: Whether sex differences exist in the inflammatory response after ST-elevation myocardial infarction (STEMI) remains to be elucidated. We studied leukocyte profiles and their prognostic value in men and women presenting with STEMI. Methods: From a total of 552 consecutive STEMI patients, blood samples were collected at hospital admission. Linear regression was used to assess the relationship between leukocyte profiles and enzymatic infarct size. Cox regression was used to assess the association between leukocyte profiles and one-year mortality. Results: Women presented with higher lymphocyte counts (2.3·10 9 cells/L (IQR 1.6-3.1) vs. 1.8·10 9 cells/L (IQR 1.4-2.5), p = 3.00 · 10 −4 ) and percentages (21. 1% (IQR 14.4-28.1) vs. 17.1% (IQR 12.3-24.3), p = 0.004). Lymphocyte to monocyte ratio (LMR) was also higher in women (3.25 (IQR 2.56-4.5) vs. 2.68 (IQR 2.08-3.59), p = 7.28 · 10 −7 ). Higher LMR was associated with lower peak CK-MB (β = −0.27 (95% CI: −0.50, −0.03), p = 0.026), lower peak troponin T (β = −0.45 (95% CI: −0.77, −0.13), p = 0.006) and lower one-year mortality risk (HR 0.35 (95% CI: 0.13, 0.96), p = 0.042). Conclusion: At admission for STEMI, women present with higher lymphocyte count and LMR. Higher LMR is associated with smaller infarct size and decreased one-year mortality risk and could be used as a biomarker to predict outcome.

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Sex differences in characteristics and outcome in acute coronary syndrome patients in the Netherlands

Cited by 33 publications

References 31 publications

Thyroid Dysfunction in Patients Admitted in Cardiac Care Unit: Prevalence, Characteristic and Hospitalization Outcomes

Thyroid Dysfunction in Patients Admitted in Cardiac Care Unit: Prevalence, Characteristic and Hospitalization Outcomes

The Influence of Sex on Navigating Acute Coronary Syndrome: A Hospital-Based Cohort Study in South Asia

Sex differences in leukocyte profile in ST-elevation myocardial infarction patients

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