Effects of Gender on the Number of Diseased Vessels and Clinical Outcome in Japanese Patients With Acute Coronary Syndrome.

Oe, Kotaro; Shimizu, Masami; Ino, Hidekazu; Yamaguchi, Masato; Terai, Hidenobu; Hayashi, Kenshi; Kiyama, Masaru; Sakata, Kenji; Hayashi, Tatsumi; Inoue, Masato; Kaneda, Tomoya; Mabuchi, Hiroshi

doi:10.1253/circj.66.435

Cited by 23 publications

(27 citation statements)

References 24 publications

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“…Thus, the effect of gender on the in-hospital management of patients with AMI remains controversial. 1,[4][5][6][7][8][9][10][11][12] In addition, our previous retrospective study, TAMIS,13) demonstrated that the gender differences in AMI management are different between younger and older populations, which is consistent with the findings of another study.…”

supporting

confidence: 79%

Age Differences in the Delivery of Cardiac Management to Women Versus Men With Acute Myocardial Infarction An Evaluation of the TAMIS-II Data

et al. 2006

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SUMMARYIt is of concern that women are more likely to undergo fewer diagnostic tests and receive less treatment for acute myocardial infarction (AMI) than men. Our retrospective Tokai Acute Myocardial Infarction Study (TAMIS) indicated that there were gender differences according to age groups; however, the exact nature of these gender differences remains unclear. Therefore, using data from TAMIS-II, we studied the influence of gender on the delivery of cardiac management according to 2 age groups (< 65, ≥ 65). TAMIS-II is a prospective study of all consecutive patients admitted to the 15 acute care hospitals in the Tokai region with the diagnosis of AMI from 2001 to 2003. A total of 169 younger women, 1246 younger men, 616 older women, and 1240 older men were included. Data on patient demographics, in-hospital course, comorbid conditions, electrocardiography (ECG), ultrasound-echocardiogram (UCG), treadmill test (TMT), coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafts (CABG), intra-aortic balloon pump (IABP), mechanical ventilation, and in-hospital or discharge medications (thrombolytics, vasopressors, aspirin, β-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium antagonists, nitrates) were collected. After controlling for these baseline variables, only lipid-lowering therapy tended to be more frequent in women than in men among the elderly (OR 1.55, 95%CI 1.00-2.38). The results from this Japanese chart review study, derived from detailed clinical data, indicated that the delivery pattern of cardiac management for female and male AMI patients during hospitalization and at discharge was very similar among the younger and older populations. (Int Heart J 2006; 47: 209-217)

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supporting

confidence: 79%

Age Differences in the Delivery of Cardiac Management to Women Versus Men With Acute Myocardial Infarction An Evaluation of the TAMIS-II Data

et al. 2006

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“…Japanese women with ACS present with similar angiographic findings and hemodynamics, but have a higher in-hospital mortality rate than male patients. The present results suggest that older age may be a potential explanation for the higher in-hospital mortality in women with AMI, but female gender itself may be an important predictor for it among those with UAP (28).…”

Section: In-hospital Outcomes With Ami and Uapmentioning

confidence: 59%

Increased Cardiac Mortality in Women Compared with Men in Patients with Acute Myocardial Infarction

et al. 2004

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Objective It has been reported that women with acute myocardial infarction (AMI) have a higher short-term mortality rate than men, but the reason is not known. The profile in relation to age, gender and risk factors was evaluated to compare AMI and unstable angina pectoris (UAP).Methods Findings from 984 patients including 580 patients with AMI (129 women, 451 men) and 404 patients with UAP (131 women, 273 men) were analyzed by the South Osaka Acute Coronary Syndrome Study Group (SACS). The primary endpoint of the study was in-hospital death. The primary endpoints of interest (cardiac death) were fatal recurrent myocardial infarction, death from congestive heart failure, and sudden death.Results Cardiac death during hospitalization within 30 days in AMI was higher in women than in men (12.4% vs 6.7%, p<0.05). On the other hand, in UAP there was no significant difference between women and men (1.5% vs 0.7%, NS). The incidence of cardiac death in AMI was significantly higher for patients 75 years old and older (19.0%) than for patients less than 55 years old (4.2%), 55-64 years old (3.5%) and 65-74 years old (4.7%) (p<0.001, respectively).Conclusions Cardiac death was higher for women compared with men in patients with AMI. The worse prognosis for the AMI women patients was likely to be derived from less performance of percutaneous coronary intervention, and a high incidence of severe myocardial infarction. Further research should be focused on the analysis of various clinical backgrounds.

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“…Our retrospective analysis showed a relatively high in-hospital mortality rate among octogenarians with ACS. According to a previous report, the in-hospital death rate in a general population with ACS was approximately 8%, 14,15 whereas the mortality rate of the octogenarians analyzed in the present study was 2 to 3 times higher. These results indicate the limited contribution of PCI or CABG surgery to the short-term survival of octogenarians.…”

Section: Outcomes After Pci and Cabgcontrasting

confidence: 41%

Clinical Outcome and Quality of Life of Octogenarian Patients Following Percutaneous Coronary Intervention or Surgical Coronary Revascularization

Kamiya

Takayama

Takano

et al. 2007

Circ J

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2003, the first follow-up telephone survey was conducted to assess the survival rate and the patients' current QOL. We first confirmed whether the patients were still alive; subsequently, the survivors were asked about their current QOL with questions by a modified Seattle Angina Questionnaire (SAQ). 8 In March 2006, we conducted a second follow-up Circ J 2007; 71: 847 -854 (Received September 25, 2006; revised manuscript received March 5, 2007; accepted March 8, 2007) Background Thus far, the outcome and effect of percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery on the quality of life of octogenarian patients has not been accurately assessed in Japan. Methods and ResultsA retrospective analysis of the outcome of invasive coronary revascularization in 130 elderly patients (age, ≥80 years) with ischemic coronary disease was carried out. Their current quality of life was determined by the Seattle Angina Questionnaire. Although the in-hospital death rate was relatively high (21.6% after PCI and 14.3% after CABG surgery), the long-term outcome of the patients who did not die during the inhospital period after the PCI/CABG surgery was acceptable (5-year survival rate, >60%

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Effects of Gender on the Number of Diseased Vessels and Clinical Outcome in Japanese Patients With Acute Coronary Syndrome.

Cited by 23 publications

References 24 publications

Age Differences in the Delivery of Cardiac Management to Women Versus Men With Acute Myocardial Infarction An Evaluation of the TAMIS-II Data

Age Differences in the Delivery of Cardiac Management to Women Versus Men With Acute Myocardial Infarction An Evaluation of the TAMIS-II Data

Increased Cardiac Mortality in Women Compared with Men in Patients with Acute Myocardial Infarction

Clinical Outcome and Quality of Life of Octogenarian Patients Following Percutaneous Coronary Intervention or Surgical Coronary Revascularization

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