Advertisement

Effect of gender on outcomes of acute coronary syndromes

      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,
      • Harris D.J.
      • Douglas P.S.
      Enrollment of women in cardiovascular clinical trials funded by the National Heart, Lung, and Blood Institute.
      ,
      • Heiat A.
      • Gross C.P.
      • Krumholz H.M.
      Representation of the elderly, women, and minorities in heart failure clinical trials.
      ,
      • Bandyopadhyay S.
      • Bayer A.J.
      • O’Mahony M.S.
      Age and gender bias in statin trials.
      and studies of ACS in particular,
      • Lee P.Y.
      • Alexander K.P.
      • Hammill B.G.
      • Pasquail S.K.
      • Peterson E.D.
      Representation of elderly persons and women in published randomized trials of acute coronary syndromes.
      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,
      • Vaccarino V.
      • Parsons L.
      • Every N.R.
      • Barron H.V.
      • Krumholz H.M.
      Sex-based differences in early mortality after myocardial infarction.
      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,
      • Hochman J.S.
      • Tamis J.E.
      • Thompson T.D.
      • Weaver W.D.
      • White H.D.
      • Van de Werf F.
      • Aylward P.
      • Topol E.J.
      • Califf R.M.
      Sex, clinical presentation, and outcome in patients with acute coronary syndromes.
      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

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Harris D.J.
        • Douglas P.S.
        Enrollment of women in cardiovascular clinical trials funded by the National Heart, Lung, and Blood Institute.
        N Engl J Med. 2000; 343: 475-480
        • Heiat A.
        • Gross C.P.
        • Krumholz H.M.
        Representation of the elderly, women, and minorities in heart failure clinical trials.
        Arch Intern Med. 2002; 162: 1682-1688
        • Bandyopadhyay S.
        • Bayer A.J.
        • O’Mahony M.S.
        Age and gender bias in statin trials.
        Quart J Med. 2001; 94: 127-132
        • Lee P.Y.
        • Alexander K.P.
        • Hammill B.G.
        • Pasquail S.K.
        • Peterson E.D.
        Representation of elderly persons and women in published randomized trials of acute coronary syndromes.
        JAMA. 2001; 286: 708-713
        • Vaccarino V.
        • Parsons L.
        • Every N.R.
        • Barron H.V.
        • Krumholz H.M.
        Sex-based differences in early mortality after myocardial infarction.
        N Engl J Med. 1999; 341: 217-225
        • Hochman J.S.
        • Tamis J.E.
        • Thompson T.D.
        • Weaver W.D.
        • White H.D.
        • Van de Werf F.
        • Aylward P.
        • Topol E.J.
        • Califf R.M.
        Sex, clinical presentation, and outcome in patients with acute coronary syndromes.
        N Engl J Med. 1999; 341: 226-232
        • Hasdai D.
        • Behar S.
        • Wallentin L.
        • Danchin N.
        • Gitt A.K.
        • Boersma E.
        • Fioretti P.M.
        • Simoons M.L.
        • Battler A.
        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