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. 2020 Feb 28;16(4):781-788.
doi: 10.5114/aoms.2018.76112. eCollection 2020.

Gender-related disparities in the treatment and outcomes in patients with non-ST-segment elevation myocardial infarction: results from the Polish Registry of Acute Coronary Syndromes (PL-ACS) in the years 2012-2014

Łukasz Piątek  1   2 , Krzysztof Wilczek  3 , Jacek Kurzawski  2 , Marek Gierlotka  4 , Mariusz Gąsior  3 , Lech Poloński  3 , Marcin Sadowski  1   5
Affiliations

Gender-related disparities in the treatment and outcomes in patients with non-ST-segment elevation myocardial infarction: results from the Polish Registry of Acute Coronary Syndromes (PL-ACS) in the years 2012-2014

Łukasz Piątek et al. Arch Med Sci. .

Abstract

Introduction: Gender-related differences in the treatment of patients with non-ST elevation myocardial infarction (NSTEMI) have been reported in many previous studies despite the fact that an equal approach is recommended in all current guidelines. The aim of the study was to investigate whether gender-related discrepancies in the management of NSTEMI patients have changed.

Material and methods: Between 2012 and 2014 a total of 66,667 patients (38.3% of whom were women) with the final diagnosis of NSTEMI were included into the retrospective analysis of the Polish Registry of Acute Coronary Syndromes (PL-ACS). Differences in clinical profile, treatment, and outcomes were analysed.

Results: Women were older than men and more often had comorbidities. They were less likely to undergo coronary angiography (88.4% vs. 92.1%, p < 0.05) as well as percutaneous coronary intervention (59.6% vs. 71.9%, p < 0.05). In the general population women had also significantly worse in-hospital prognosis as well as in 12-month follow-up. After the age adjustment the outcomes in women were at least as good as in men. In multivariate analysis females had the same risk as men in-hospital RR = 1.02 (95% CI: 0.97-1.08, p = 0.45) and lower in 12-month observation RR = 0.94 (95% CI: 0.92-0.97, p < 0.0001).

Conclusions: In comparison with previous reports on NSTEMI patients, gender-related disparities in the treatment and outcomes were radically reduced. Unadjusted mortality rates were still higher in women as a consequence of their older age. After the age adjustment, mortality ratios were similar in both genders. The long-term prognosis seems to be even better in women.

Keywords: elderly; invasive treatment; mortality; non-ST elevation myocardial infarction; women.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Age histogram of patients with non-ST elevation myocardial infarction in 2012–2014
Figure 2
Figure 2
The elderly contribution in patients with non-ST elevation myocardial infarction in 2012–2014
Figure 3
Figure 3
In-hospital mortality rates in consecutive decades of life
Figure 4
Figure 4
12-month mortality rates in the consecutive ecades of life
Figure 5
Figure 5
12-month mortality in age groups: A – age < 55, B – age 55–64, C – age 65–74, D – age ≥ 75 years
Figure 6
Figure 6
12-month mortality adjusted to strategy of treatment: A – conservative strategy, B – invasive strategy
See this image and copyright information in PMC

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