Gender Differences in Presentation and Outcomes of Acute Coronary Syndrome: A Multicenter Study

Faiz Ullah; Atiq Ur Rehman; Rahim Dil Khan; Fareeha Naz; Ahmadyar; Ajmal Khan

doi:10.70749/ijbr.v3i4.1239

Authors

Faiz Ullah Department of Cardiology, Hayatabad Medical Complex Peshawar, Pakistan
Atiq Ur Rehman Peshawar Institute of Cardiology, Pakistan
Rahim Dil Khan Department of Cardiology, Hayatabad Medical Complex Peshawar, Pakistan
Fareeha Naz Shaheed Peer Muhammad Khan THQ Hospital, Puran Shangla, Pakistan
Ahmadyar THQ Hospital Tangi, Charsadda, Pakistan
Ajmal Khan Rehman College of Allied Health Science, Rehman Medical Institute, Peshawar, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i4.1239

Keywords:

Acute Coronary Syndrome, Gender Differences, Myocardial Infarction, In-Hospital Outcomes, Pakistan

Abstract

Introduction: Gender disparities in acute coronary syndrome (ACS) have been increasingly recognized, with women often experiencing atypical symptoms, delayed care, and poorer outcomes. However, limited local data are available on this subject in Pakistan. Objective: To evaluate gender-based differences in clinical presentation, management, and in-hospital outcomes among patients with ACS in a tertiary care setting. Materials and Method: A prospective observational study was conducted at Hayatabad Medical Complex Peshawar, Pakistan from June, 2024 to November, 2024. A total of 300 ACS patients (180 males and 120 females) were enrolled. Data on demographics, clinical features, treatment modalities, and outcomes were recorded and analyzed using SPSS v26. Results: Female patients were older, had more comorbidities, and presented more frequently with atypical symptoms. They experienced longer delays in hospital presentation, lower rates of reperfusion therapy, and higher rates of complications and in-hospital mortality compared to males. Conclusion: Significant gender disparities exist in ACS presentation and outcomes, warranting gender-sensitive diagnostic and treatment strategies.

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References

Lee, C.Y., Liu, K.T., Lu, H.T., Mohd Ali, R., Fong, A.Y.Y. and Wan Ahmad, W.A., 2021. Sex and gender differences in presentation, treatment and outcomes in acute coronary syndrome, a 10 year study from a multi-ethnic Asian population: The Malaysian National Cardiovascular Disease Database—Acute Coronary Syndrome (NCVD-ACS) registry. PLoS One, 16(2), p.e0246474.

https://doi.org/10.1371/journal.pone.0246474

Elia, E., Bruno, F., Crimi, G., Wańha, W., Leonardi, S., Mauro, M., Roubin, S.R., Fabris, E., Giannino, G., Mancone, M. and Severino, P., 2024. Gender differences in the development of heart failure after acute coronary syndrome: Insight from the CORALYS registry. International Journal of Cardiology, 397, p.131622.

https://doi.org/10.1016/j.ijcard.2023.131622

Zhou, S., Zhang, Y., Dong, X., Zhang, X., Ma, J., Li, N., Shi, H., Yin, Z., Xue, Y., Hu, Y. and He, Y., 2023. Sex disparities in management and outcomes among patients with acute coronary syndrome. JAMA network open, 6(10), pp.e2338707-e2338707.

https://doi.org/10.1001/jamanetworkopen.2023.38707

Lunova, T., Komorovsky, R. and Klishch, I., 2023. Gender differences in treatment delays, management and mortality among patients with acute coronary syndrome: a systematic review and meta-analysis. Current Cardiology Reviews, 19(1), pp.111-126.

https://doi.org/10.2174/1573403x18666220630120259

Cader, F.A., Banerjee, S. and Gulati, M., 2022. Sex differences in acute coronary syndromes: a global perspective. Journal of Cardiovascular Development and Disease, 9(8), p.239.

https://doi.org/10.3390/jcdd9080239

De Rosa, R., Morici, N., De Luca, G., De Luca, L., Ferri, L.A., Piatti, L., Tortorella, G., Grosseto, D., Franco, N., Misuraca, L. and Sganzerla, P., 2021. Association of sex with outcome in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention. The American Journal of Medicine, 134(9), pp.1135-1141.

https://doi.org/10.1016/j.amjmed.2021.03.025

Huber, E., Le Pogam, M.A. and Clair, C., 2022. Sex related inequalities in the management and prognosis of acute coronary syndrome in Switzerland: cross sectional study. BMJ medicine, 1(1), p.e000300.

https://doi.org/10.1136/bmjmed-2022-000300

Lv, J., Ni, L., Liu, K., Gao, X., Yang, J., Zhang, X., Ye, Y., Dong, Q., Fu, R., Sun, H. and Yan, X., 2021. Clinical characteristics, prognosis, and gender disparities in young patients with acute myocardial infarction. Frontiers in Cardiovascular Medicine, 8, p.720378.

https://doi.org/10.3389/fcvm.2021.720378

Gauthier, V., Montaye, M., Ferrières, J., Kai, S.H.Y., Biasch, K., Moitry, M., Amouyel, P., Dallongeville, J. and Meirhaeghe, A., 2022. Sex differences in time trends in acute coronary syndrome management and in 12-month lethality: data from the French MONICA registries. International Journal of Cardiology, 361, pp.103-108.

https://doi.org/10.1016/j.ijcard.2022.05.040

Negrea, M.O., Zdrenghea, D., Teodoru, M., Neamțu, B., Cipăian, C.R. and Pop, D., 2022. Gender particularities and prevalence of atypical clinical presentation in non-ST elevation acute coronary syndrome. Journal of Cardiovascular Development and Disease, 9(3), p.84.

https://doi.org/10.3390/jcdd9030084

Weininger, D., Cordova, J.P., Wilson, E., Eslava, D.J., Alviar, C.L., Korniyenko, A., Bavishi, C.P., Hong, M.K., Chorzempa, A., Fox, J. and Tamis-Holland, J.E., 2022. Delays to hospital presentation in women and men with ST-segment elevation myocardial infarction: a multi-center analysis of patients hospitalized in New York City. Therapeutics and Clinical Risk Management, pp.1-9.

https://doi.org/10.2147/tcrm.s335219

Occhipinti, G., Greco, A., Angiolillo, D.J. and Capodanno, D., 2023. Gender differences in efficacy and safety of antiplatelet strategies for acute coronary syndromes. Expert Opinion on Drug Safety, 22(8), pp.669-683.

https://doi.org/10.1080/14740338.2023.2245331

Hyun, K., Negrone, A., Redfern, J., Atkins, E., Chow, C., Kilian, J., Rajaratnam, R. and Brieger, D., 2021. Gender difference in secondary prevention of cardiovascular disease and outcomes following the survival of acute coronary syndrome. Heart, Lung and Circulation, 30(1), pp.121-127.

https://doi.org/10.1016/j.hlc.2020.06.026

Sotorra-Figuerola, G., Ouchi, D., García-Sangenís, A., Giner-Soriano, M. and Morros, R., 2022. Pharmacological treatment after acute coronary syndrome: baseline clinical characteristics and gender differences in a population-based cohort study. Atencion Primaria, 54(1), p.102157.

https://doi.org/10.1016/j.aprim.2021.102157

Kytö, V., Sipilä, J., Rautava, P. and Gunn, J., 2021. Sex differences in outcomes following acute coronary syndrome treated with coronary artery bypass surgery. Heart, Lung and Circulation, 30(1), pp.100-107.

https://doi.org/10.1016/j.hlc.2020.02.009