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Gender equality in acute coronary syndrome: modern times, old habits?
Session:
Posters 5 - Écran 10 - Economia na Saúde / Saúde Pública
Speaker:
Nuno Craveiro
Congress:
CPC 2019
Topic:
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
Theme:
34. Public Health and Health Economics
Subtheme:
34.1 Public Health
Session Type:
Posters
FP Number:
---
Authors:
Nuno Craveiro; Mariana Saraiva; Ana Rita Moura; Maria João Matos Vieira; Kevin Domingues; Marisa Peres; Margarida Leal
Abstract
<p>INTRODUCTION: Historically, women with acute coronary syndrome (ACS) have worse outcomes compared with men. Differences in clinical, demographic characteristics and treatment may explain this result. In recent times with new diagnostic capabilities and revascularization therapies this panorama may be changing.</p> <p>METHODS: Single-center retrospective study comparing gender differences in ACS patients from 2012 to 2017. Two groups were formed comparing women and men: Group A: years 2012 to 2014 and group B: years 2015 to 2017.</p> <p>RESULTS: From 2012 to 2017 we identified 1091 patients with ACS. Of them 356 (32,6%) were women and NSTEMI (60%) was the most frequent type of ACS in this group. Women with ACS were older than men (73 vs 66 years) had more arterial hypertension (83,4% vs 68,3% p<0,001), diabetes mellitus (46,3% vs 30,9% p<0,001) and were less frequently smokers (6,5% vs 25,3% p<0,01). Dyspnea as the predominant symptom was more frequent in women (10,4 % vs 5,2% p=0,002) who had fewer coronary invasive angiography (63,2% vs 74,7% p<0,001) and the result was more frequently non obstructive disease (9,8% vs 3,3% p<0,001). In-hospital mortality was greater in the women group (7,9% vs 3,7% p=0.005). There were no differences between groups in hospitalization or cardiovascular mortality over 1-year follow-up. When comparing Group A with Group B there were differences in hospitalization at 1 year (Group A 15,4% vs 9,3% p=0,029, Group B 11% vs 12,4% p=0,766), in-hospital women mortality (Group A 9,5% vs 3,6 p=0,005, Group B 5,8 vs 3,8% p=0,346) and coronary invasive angiography (Group A 61,2% vs 80,2% p<0,001 vs Group B 65,8 vs 68,5%, p=0,606).</p> <p>CONCLUSION: Different demographic and clinical presentation as well as in-hospital and 1-year outcomes were present in our study population. While in Group A threre were significant gender differences regarding hospitalization and in-hospital mortality, those differences faded away in Group B. Efforts should be made to lessen gender differences in treatment and assistance knowing the different demographical and clinical patient profile.</p>
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