Are There Gender-Related Differences in Outcomes of Elderly NSTEACS Patients?

Elderly women with non-ST elevation acute coronary syndromes (NSTEACS) have better 1-year clinical outcomes than their male counterparts, according to a study published May 18 in JACC: Cardiovascular Interventions.

Using data from the Italian Elderly ACS study and a registry, researchers compared the treatments and outcomes in elderly patients with NSTEACS to determine gender-related differences. Of the 645 patients examined, 301 were female. The one year primary endpoints were composite of death, nonfatal myocardial infarction, disabling stroke, cardiac re-hospitalization and severe bleeding.

The results of the study showed that while elderly female and male NSTEACS patients had similar short-term outcomes, female patients had better one-year clinical outcomes. No significant differences in primary endpoints were reported. Women had lower rates of coronary revascularization compared to men (37 percent vs. 45 percent) and lower rates of re-hospitalization for cardiovascular causes (9 percent vs. 16 percent). Further, women who were not revascularized had a three-fold higher one-year mortality compared to revascularized women.

The authors of the study note that “elderly women with a NSTEACS should not be denied an evidence-based diagnostic and therapeutic approach because of an alleged excess in in-hospital mortality and severe bleeding.” 

Clinical Topics: Acute Coronary Syndromes, Geriatric Cardiology

Keywords: Acute Coronary Syndrome, Aged, Female, Hemorrhage, Hospital Mortality, Hospitalization, Male, Myocardial Infarction, Stroke

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