Gender differences among patients with acute coronary syndrome in the Middle East

Abstract

Background:There is controversy regarding the relationship between gender and acute coronary syndrome (ACS).Objective:To study the impact of gender on presentation, management, and mortality among patients with ACS in the Middle East.Methodology:From January 2012 to January 2013, 4057 patients with ACS were enrolled from four Arabian Gulf countries (Kuwait, Oman, United Arab Emirates, and Qatar), representing more than 85% of the general hospitals in each of the participating countries.Results:Compared to men, women were older and had more comorbidities. They also had atypical presentation of ACS such as atypical chest pain and heart failure. The prevalence of non-ST-segment elevation myocardial infarction (49 vs. 46%; P < 0.001) and unstable angina (34 vs. 24%; P < 0.001) was higher among women as compared to men. In addition, women were less likely to receive evidence-based medications such as aspirin, clopidogrel, beta-blocker, and angiotensin-converting enzyme inhibitors on admission and on discharge. During hospital stay, women suffered more heart failure (15 vs. 12%; P = 0.008) and were more likely to receive blood transfusion (6 vs. 3%; P < 0.001). Women had higher 1-year mortality (14 vs. 11%; P < 0.001), the apparent difference that disappeared after adjusting for age and other comorbidities.Conclusion:Although there were differences between men and women in presentation, management, and in-hospital outcomes, gender was shown to be a nonsignificant contributor to mortality after adjusting for confounders.

Acute Myocardial Infarction among Hospitalizations for Heat Stroke in the United States

“…This is supported by the fact that chronic kidney disease and obesity are risk factors of cardiovascular diseases [19,20]. While smoking, diabetes mellitus, and hypertension are well known major risk factors of myocardial infarction [21,22], they were not demonstrated at a statistically significant level in multivariable analysis in our study. Although the underlying explanation remains unclear, it is possible that myocardial infarction among patients with heat stroke is type 2 myocardial infarction that occurs secondary to an acute imbalance in myocardial oxygen supply and demand without atherothrombosis [23,24].…”

Triple Versus Dual Antiplatelet Therapy in Patients With Acute Coronay Syndrome Undergoing Percutaneous Coronary Intervention (Pci) in SCB Medical College, Cuttack, Odisha, India.

“…Table 5 depicts the follow up symptoms at 1 , 3 and 6 months follow up. Most patients were asymptomatic at follow up visits same supported by Fischman DL et al 18 , followed by chest pain and bleeding manifestations. Fatal myocardial infarction was observed in 4(2%) at 1 month , 3(1.5%) at 3 months, and 7(3.5%) at 6 months follow up.…”

Impact of Age on Risk Factors and Clinical Manifestations of Acute Coronary Syndrome: Observations From the Coronary Care Unit of Sulaimani, Iraq

“…This finding is in good agreement with previous studies that have referred to male gender as a risk factor for ACS. 26,[28][29][30] Hypertension was found to be the most frequent risk factor among the studied AMI patients, such that 65 cases (54.4%) had hypertension. Other most frequent risk factors were observed to be dyslipidemia (52%), smoking (42.4%), diabetes mellitus (38.4%), obesity (24%), family history (14.4%), and physical inactivity (3.2%).…”