Gender-related differences in clinical course, therapeutic approach and prognosis in patients with non-ST segment elevation myocardial infarction.

Background: There is accumulated evidence that clinical course and prognosis after myocardial infarction (MI) may differ between genders.

Aim: To compare epidemiology, the clinical course, therapeutic approach and prognosis in men and women with non-ST segment elevation MI (NSTEMI).

Methods: We analysed a total of 1219 consecutive patients with NSTEMI (43% women) treated between June 01, 2005 and May 31, 2006 in a hospital covering in a district with 1,300,000 inhabitants. The data were obtained from the Polish Registry of Acute Coronary Syndromes (PL-ACS).

Results: Women in the study group were on average 6 years older than men (72.6 ± 10.3 vs 66.7 ± 11.4 years; p < 0.0001). The incidence of arterial hypertension (83.4% vs 73.45%; p < 0.0001), diabetes mellitus (30.2% vs 20.1%; p < 0.0001) and obesity (17.9% vs 13.1%; p < 0.020) was higher in women, while cigarette smoking was more common in men (7.4% vs 32.9%; p < 0.0001). Clinical presentation was similar in both genders. Coronary angiography was performed in 360 patients, more frequently in men (32.8% vs 25.2%; p < 0.05). Less women than men underwent percutaneous coronary angioplasty (18.9% vs 12.6%; p < 0.0033). In-hospital, 30-day and 6-month mortality was similar in both genders (5.3% vs 4.9%; 6.9% vs 7.3%; and 13.2% vs 13.1%, respectively). In a multivariate analysis, female gender did not influence the prognosis.

Conclusions: Although women with NSTEMI had worse baseline characteristic and less frequently underwent revascularisation, their outcomes were comparable with those in men.