Gender disparities in acute coronary syndrome

Ghadri, Jelena R.; Sarcon, Annahita; Jaguszewski, Miłosz; Diekmann, Johanna; Bataiosu, Roxana D.; Hellermann, Jens; Csordás, Adam; Baumann, Lukas; Schöni, Aline A.; Lüscher, Thomas F.; Templin, Christian

doi:10.2459/jcm.0000000000000248

Cited by 23 publications

(9 citation statements)

References 32 publications

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“…For future personalized diagnosis and prognosis in ACS and HF patients, a temporal multimarker approach could be employed to monitor the functions of different biological pathways over time. For example, markers for status of cardiac damage (hs-cTnI), markers for pathophysiological status (CRP and other cytokines), and markers for cardiac dysfunction (BNP) can be monitored over time as a multi-marker panel [ 56 – 58 ].…”

Section: Methodsmentioning

confidence: 99%

Sex differences in ischemic heart disease and heart failure biomarkers

Castro

Gottlieb

et al. 2018

Biol Sex Differ

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Since 1984, each year, more women than men die of ischemic heart disease (IHD) and heart failure (HF), yet more men are diagnosed. Because biomarker assessment is often the first diagnostic employed in such patients, understanding biomarker differences in men vs. women may improve female morbidity and mortality rates.Some key examples of cardiac biomarker utility based on sex include contemporary use of “unisex” troponin reference intervals under-diagnosing myocardial necrosis in women; greater use of hsCRP in the setting of acute coronary syndrome (ACS) could lead to better stratification in women; and greater use of BNP with sex-specific thresholds in ACS could also lead to more timely risk stratification in women.Accurate diagnosis, appropriate risk management, and monitoring are key in the prevention and treatment of cardiovascular diseases; however, the assessment tools used must also be useful or at least assessed for utility in both sexes. In other words, going forward, we need to evaluate sex-specific reference intervals or cutoffs for laboratory tests used to assess cardiovascular disease to help close the diagnostic gap between men and women.

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Section: Methodsmentioning

confidence: 99%

Sex differences in ischemic heart disease and heart failure biomarkers

Castro

Gottlieb

et al. 2018

Biol Sex Differ

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“…Among the 41 cross-sectional studies assessed by the Axis checklist, all those studies had "Yes" answer for questions number 1, 2, 4, 5, 6, 9, 10, 11, 12, 15, 16, and 17 and "No" answer for question number 3 and 14. Eighteen studies did not measure and categorize the non-responders [6], [7], [9], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26]. There were nine studies [10], [18], [24], [27], [28], [29], [30], [31], [32] collecting data on statin use directly from the patients either by interview or selfreporting.…”

Section: Study Qualitymentioning

confidence: 99%

“…By assessing the quality among the selected studies related to question number 13, missing data/ loss to follow-up was higher than 20% in the three studies [28], [33], [34]. Referring to question number 18, six studies [8], [15], [21], [35], [36], [37] did not report their study limitation in the discussion part. Thirteen out of 41 studies declared their conflict of interest according to question number 19 in the checklist [9], [10], [16], [18], [19], [24], [26], [28], [33], [34], [38], [39], [40].…”

Section: Study Qualitymentioning

confidence: 99%

“…Thirteen out of 41 studies declared their conflict of interest according to question number 19 in the checklist [9], [10], [16], [18], [19], [24], [26], [28], [33], [34], [38], [39], [40]. Twelve studies did not receive the ethic committee approval nor the participant consent [6], [8], [14], [19], [21], [24], [25], [26], [33], [37], [38], [41]. The details of the assessment are presented in Table 1.…”

Section: Study Qualitymentioning

confidence: 99%

“…Several studies reported the utilization rate of statin by age and gender. Of the included studies, seven studies compared statin utilization between male and female groups [6], [13], [21], [34], [39], [41], [54]. All of these studies reported that the use of statin was lower in females than males.…”

Section: Statin Utilizationmentioning

confidence: 99%

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Statin Utilization among Patients with Acute Coronary Syndrome: Systematic Review

Dewi¹,

Thavorncharoensap²

2021

Open Access Maced J Med Sci

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BACKGROUND: The early use of statin with intensive regimen has been recommended by the recent guidelines as the prevention of acute coronary syndrome (ACS) related events among the high-risk patients. Meanwhile, the inconsistent statin utilization for targeted patient in current practice is still an issue. AIM: This study aims to review the utilization rate of statin among patients with ACS. METHODS: A systematic search of relevant studies published between inceptions to June 2020 was conducted in PubMed. Patients and intervention domains were used to build up the searching formula. A study was eligible for inclusion if it was an original study of patients with ACS and it examined the utilization of statin. The risk of bias was assessed using Axis and NOS checklist. RESULTS: Among the 49 eligible studies, 38 were cohort studies while the others were cross-sectional studies. The utilization rate of statin at hospital admission ranged from 16% to 61% while 25% to 75% during the hospitalization. Of the total studies, 35 studies reported the statin rate at discharge ranging from 58% to 99%. Almost all studies revealed the reduction of statin utilization rate along the follow-up period. The number of statins prescribed was found to be lower among female and elderly patients. CONCLUSION: Despite the established benefits of statin among patients with ACS, our study revealed that statin was underutilized for secondary prevention after ACS. To improve patients’ clinical outcomes with ACS, efforts should be made to increase optimal treatment and compliance with a statin.

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Gender and age differences in outcomes of patients with acute coronary syndromes referred for coronary angiography

Stähli

Wischnewsky

Jakob

et al. 2018

Cathet Cardio Intervent

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Objectives The number of elderly patients undergoing coronary revascularization is steadily increasing, and data on the impact of gender on outcomes are scarce. This study sought to assess gender‐related differences in outcomes in elderly patients with acute coronary syndromes (ACS). Methods We investigated outcomes in elderly ACS patients referred for coronary angiography and prospectively enrolled in the Swiss ACS Cohort between December 2009 and October 2012. Adjudicated major adverse cardiovascular and cerebrovascular events (MACCE) included all‐cause death, non‐fatal myocardial infarction, clinically indicated repeat coronary revascularization, definite stent thrombosis, and transient ischemic attack/stroke. Results Among 2,168 patients recruited, 481 (22%) patients were >75 years of age (37% women). In patients >75 years, 1‐year MACCE rates were 15% and 23% in women and men (OR 0.59, 95% CI 0.36–0.97, P = 0.04), respectively, and differences remained significant after adjustments for baseline variables (adjusted OR 0.48, 95% CI 0.26–0.90, P = 0.02). Women >75 years had a lower cardiovascular mortality (6% versus 12%, adjusted OR 0.31, 95% CI 0.12–0.81, P = 0.02). In patients ≤75 years, 1‐year MACCE rates did not differ between gender (10% and 8% for women and men, adjusted OR 1.28, 95% CI 0.77–2.14, P = 0.34). Rates of TIMI major bleeding for women and men were 4% and 4% in patients >75 years (P = 0.96), and 5% and 3% in those ≤75 years (P = 0.11). Conclusions The low rates of MACCE observed in elderly women in this patient cohort suggest that with current interventional strategies the gender gap in ACS management has been attenuated.

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Gender disparities in acute coronary syndrome

Cited by 23 publications

References 32 publications

Sex differences in ischemic heart disease and heart failure biomarkers

Sex differences in ischemic heart disease and heart failure biomarkers

Statin Utilization among Patients with Acute Coronary Syndrome: Systematic Review

Gender and age differences in outcomes of patients with acute coronary syndromes referred for coronary angiography

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