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Acute coronary syndrome outcomes similar among the sexes, study finds

By Jane Lewis 
Men and women who have experienced premature acute coronary syndrome (ACS) have similar outcomes at one year in terms of mortality and major adverse cardiac events, reports a prospective study published in the Canadian Journal of Cardiology

According to the authors, although the incidence of ACS and other coronary heart disease (CHD) among younger adults (age <55 years) appears to be increasing, data about outcomes are still scarce and sex differences have been understudied. 

Commenting for Cardiology Today, Dr Jennifer Johns, National Heart Foundation President and Cardiologist at Austin Hospital, Melbourne, said it was ‘a very good, contemporary study’ featuring ‘a decent cohort’ of patients from countries with a high standard of medical care. ‘This research is really interesting, because it clearly shows similar outcomes in men and women at 12 months,’ she said. 

The study followed 1163 patients younger than 55 years of age in three countries (Canada, Switzerland and the USA) who were admitted to hospital with a diagnosis of ACS. Similar rates of mortality (1% in both men and women) and major adverse cardiac events (9% in men and 8% in women) were found among the sexes. Women were more likely than men to be rehospitalised (13% vs 9%), but there was no difference between the sexes when looking specifically at cardiac-related rehospitalisation. In both sexes, most first rehospitalisations were cardiac related (69%), with chest pain or angina (28%) and myocardial infarction (19%) being the most common reasons. 

The authors suggested there may be several possible reasons why their results differed from those of earlier studies, including that diagnosis, treatment and secondary prevention in younger women has recently improved. 

The authors of an accompanying editorial, which described the study’s findings as ‘reassuring,’ concurred. ‘There are numerous reasons why contemporary data might show the absence of a sex gap,’ they stated, citing higher procedure rates, better medical management of ACS, and increased recognition and enhanced treatment of the causes of ACS in women as examples. 

‘We now have very good evidence that with appropriate intervention, you can obtain outcomes in women with ACS that are just as good as those in men,’ said Dr Johns.
Can J Cardiol 2016;
Can J Cardiol 2016;

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