Gender based differences in acute coronary syndrome

Abstract

INTRODUCTION AND OBJECTIVES: To describe gender based differences in demographics, risk factors, management and early outcome in Sri Lankan patients with acute coronary syndromes (ACS). Methods: All adults admitted with ACS to medical units of Colombo North Teaching Hospital are enrolled in a prospective Registry. We studied data obtained from patients admitted over a period of 11/2 years. RESULTS: 765 patients were studied (56.9% males). Females were likely to be older [mean age years (SD) - male 59.5(11.4), female 62.9(11.4), pO.OOl]. Women were more likely to have unstable angina (female -56.4%, male- 40,0%)7 while men were more likely to have ST elevated myocardial infarction (M-36.6%? 19.4%) (pO.OOl). Several risk factors were commoner in women (p<0.001): hypertension-female- 70%, male- 49.6%; diabetes - female- 49.7%, male- 35.6%; hyperlipidaemia - female-73.6%, male-56.6%; high waist circumference- female 65.8%, male-29.8%. Smoking and alcohol use were almost exclusively seen in men (75.9% and 84.6% respectively vs. 1.2% and 1.5%; /K0.001). 32.4% of women and 37.6% of men had previous IHD (p=0.079). Women were more likely to be on pre-admission antiplatelet, statin, beta blocker and ACE inhibitor therapy (/7<0.005). Five patients died. There were no differences in care given and early outcome. CONCLUSIONS: There are important gender-related differences in the pattern of ACS in Sri Lankan patients. Several modifiable cardiovascular risk factors were commoner in women, highlighting the need for targeted preventive strategies. Acknowledgements: Japan International Cooperation Agency