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. 2019 May;27(5):263-271.
doi: 10.1007/s12471-019-1271-0.

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

M E Ten Haaf  1   2 , M Bax  3 , J M Ten Berg  4 , J Brouwer  5 , A W Van't Hof  6   7 , R J van der Schaaf  8 , P R Stella  9 , R M Tjon Joe Gin  10 , P A Tonino  11 , A G de Vries  12 , F Zijlstra  13 , E Boersma  13 , Y Appelman  14
Affiliations

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

M E Ten Haaf et al. Neth Heart J. 2019 May.

Abstract

Background: Sex differences in acute coronary syndrome (ACS) have been reported, but little is known about the situation in the Netherlands.

Methods: This registry is a merge of available data on ACS patients in the electronic data capture systems of 11 centres with 24/7 interventional cardiology services. We included patients >18 years undergoing a cardiac catheterisation between 2010-2012. We evaluated sex differences in clinical and procedural characteristics and 1‑year mortality.

Results: A total of 29,265 ACS patients (8,720 women and 20,545 men) were registered. Women were on average 4.5 years older (68.5 vs 63.0 years, p < 0.001) and had a higher prevalence of hypertension (62.7 vs 49.8%, p < 0.001) and insulin-dependent diabetes mellitus (9.6 vs 6.8%, p < 0.001) than men. Women less often presented with ST-elevation myocardial infarction (43.7% vs 47.6%, p < 0.001) and appeared to have less extensive coronary artery disease than men. Women less often underwent coronary angiography by radial access (52.5 vs 55.9%, p < 0.001). One-year mortality was higher in women than in men (7.3% and 5.6%, p < 0.001). More specific, the relationship between sex and mortality was age-dependent and showed higher mortality in women ≤71 years, but lower mortality in older women compared with men (p-interaction <0.001).

Conclusion: We found differences in clinical and procedural characteristics and outcome between women and men admitted for ACS, which are in line with other Western countries. The limitations of our registry, based on existing local databases, can be overcome by the use of the prospective Netherlands Heart Registry that is currently in development.

Keywords: Acute coronary syndrome; Registry; Sex differences.

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Conflict of interest statement

M.E. ten Haaf, M. Bax, J.M. ten Berg, J. Brouwer, A.W. van’t Hof, R.J. van der Schaaf, P.R. Stella, R.M. Tjon Joe Gin, P.A. Tonino, A.G. de Vries, F. Zijlstra, E. Boersma and Y. Appelman declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Geographical distribution of participating interventional centres. Geographical distribution of participating interventional centres. Green dots represent participating centres, red dots represent non-participating centres
Fig. 2
Fig. 2
Study patients according to sex and age. Study patients by sex and age. Upper part shows percentage of the total study sample of ACS patients by sex, bottom part shows percentage of women per age stratum. ACS acute coronary syndrome
Fig. 3
Fig. 3
Kaplan-Meier curves for all-cause mortality according to sex and age stratum up to 1‑year follow-up. Kaplan-Meier curves for all-cause mortality in ACS patients according to sex and age stratum up to 1‑year follow-up. ACS acute coronary syndrome
Fig. 4
Fig. 4
Adjusted all-cause 1‑year mortality of the sex*age interaction. Adjusted all cause 1‑year mortality of the sex and age interaction. Red line represents women, blue line represents men with ACS. ACS acute coronary syndrome
See this image and copyright information in PMC

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