A major source for information regarding treatment and outcome of acute coronary syndrome
(ACS) is the data derived from randomized clinical trials. However, cardiovascular
clinical trials in general,
1
,
2
,
3
and studies of ACS in particular,
4
are fraught with a bias against the inclusion of women. Therefore, the data derived
from clinical trials may not be pertinent to the “real world scenario.” Although a
recent report from a very large registry of patients with acute myocardial infarction
(AMI) in the United States confirmed a worse prognosis for women, but only among younger
women,
5
ACS encompasses a wider spectrumthan AMI. With the emergence of unstable angina pectoris
as a major diagnosis of ACS in higher proportions of women, and the prospect of a
better prognosis,
6
there is a need for further study. In the present study, we analyzed this issue in
a prospective registry of a wide spectrum of “real-world” patients with ACS.To read this article in full you will need to make a payment
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References
- Enrollment of women in cardiovascular clinical trials funded by the National Heart, Lung, and Blood Institute.N Engl J Med. 2000; 343: 475-480
- Representation of the elderly, women, and minorities in heart failure clinical trials.Arch Intern Med. 2002; 162: 1682-1688
- Age and gender bias in statin trials.Quart J Med. 2001; 94: 127-132
- Representation of elderly persons and women in published randomized trials of acute coronary syndromes.JAMA. 2001; 286: 708-713
- Sex-based differences in early mortality after myocardial infarction.N Engl J Med. 1999; 341: 217-225
- Sex, clinical presentation, and outcome in patients with acute coronary syndromes.N Engl J Med. 1999; 341: 226-232
- A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin.Eur Heart J. 2002; 23: 1190-1201
Article Info
Publication History
Accepted:
March 17,
2003
Received in revised form:
March 15,
2003
Received:
December 2,
2002
Footnotes
☆This study was sponsored by Schering-Plough, Kenilworth, New Jersey, and Centocor, Malvern, Pennsylvania.
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
