Gender-Based Differences in the Management and Prognosis of Acute Coronary Syndrome in Korea.
10.3349/ymj.2011.52.4.562
- Author:
Hee Tae YU
1
;
Kwang Joon KIM
;
Woo Dae BANG
;
Chang Myung OH
;
Ji Yong JANG
;
Sung Soo CHO
;
Jung Sun KIM
;
Young Guk KO
;
Donghoon CHOI
;
Myeong Ki HONG
;
Yangsoo JANG
Author Information
1. Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea. cdhlyj@yuhs.ac
- Publication Type:Original Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
- Keywords:
Acute coronary syndrome;
gender identity;
Korea;
prognosis;
introduction
- MeSH:
Acute Coronary Syndrome/complications/*diagnosis/therapy;
Adult;
Age Factors;
Aged;
Female;
Humans;
Male;
Middle Aged;
Prognosis;
Prospective Studies;
Republic of Korea;
Sex Factors
- From:Yonsei Medical Journal
2011;52(4):562-568
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Gender-based differences exist in the characteristics, management, and prognosis of acute coronary syndrome (ACS). However, their impact on prognosis remains unclear. We aimed to identify factors causing these differences in Koreans. MATERIALS AND METHODS: We examined 6,636 ACS patients (66.2% males) visiting 72 Korean hospitals between April-2007 and December-2008. Gender-based differences in clinical demographics, therapy, and outcomes were analyzed over 6 months. RESULTS: Women were older than men [mean (standard deviation, SD) age, 67.6 (9.8) vs. 60.6 (11.2) years; p<0.001]; had higher rates of hypertension, diabetes mellitus, and lack of exercise (p<0.001 for all); and lower rates of obesity, familial history of cardiovascular disease (CVD), and smoking (p<0.05 for all). Atypical symptoms were more common in women (20.5% vs. 15.1% in men, p<0.001), whereas myocardial infarction with ST-segment elevation was less common (17.1% vs. 27.8%, p<0.001). Mean (SD) time lapse from symptom onset to arrival at hospital was longer in women [11.44 (18.19) vs. 8.26 (14.89) hours in men, p<0.001], as was the duration of hospitalization [7.58 (7.61) vs. 7.04 (7.72) days, p=0.007]. Fewer women underwent revascularization procedures, including thrombolytic therapy, balloon angioplasty, stent implantation, and coronary artery bypass grafting (79.4% vs. 83.3% men, p<0.001). No significant differences were observed in CVD-related death, recurrent ACS, stroke, refractory angina, or rehospitalization for angina. CONCLUSION: Female ACS patients were older than male subjects and had more atypical presentation. They arrived at the hospital later than men and had longer hospital stays, but less often required revascularization therapy. However, no gender-based differences were noted in ACS-related mortality and morbidity.
