Unveiling the gender gap in ST-elevation myocardial infarction: a retrospective analysis of a single Italian center gender disparities in STEMI-ACS

Abstract

The gender gap in healthcare has been a topic of concern for a long time. Acute coronary syndromes (ACS) remain a leading cause of morbidity and mortality worldwide. Extensive research has demonstrated that women often experience different ACS clinical presentations and treatment responses in comparison with men, leading to diagnostic challenges and gender disparities in ACS management and outcomes. [1][2][3][4] Recent findings on the impact of coronary revascularization in women with ACS underscored the need for specific treatment protocols to address their anatomical and physiological specificities. 5-10 Moreover, a critical analysis by Moscucci highlights the need for a comprehensive, patient-centered approach that considers the unique biological, sociocultural and psychological factors influencing ACS outcomes in women. 9 Despite growing awareness, gender disparities in ACS persist, largely because of diagnostic challenges that may prevent appropriate and timely care in female patients. 2 The aim of our study is to evaluate the existence of gender differences in the diagnosis and treatment of patients with ST-elevation myocardial infarction (STEMI) at our tertiary center. MethodsWe performed a retrospective cohort study of adult patients admitted to our Cardiac Intensive Care Unit (CICU) with a diagnosis of STEMI from January 2014 to July 2022. We investigated the presence of gender differences in time from symptoms onset to revascularization, time from admission to revascularization, intra-hospital mortality and 1-year outcome.