Sex-related differences in care and prognosis in acute coronary syndrome

Objective: This study investigates differences based on sex in prognosis for acute coronary syndrome using data of 76,153 patients in Hungary's National Myocardial Infarction Register, focusing on all-cause mortality, risk factors, and treatment outcomes. Methods: The data set analyzed is the r...

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Main Authors: Csaba Sári, Christian M. Heesch, Attila János Kovács, Péter Andréka
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Preventive Medicine Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2211335525001706
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author Csaba Sári
Christian M. Heesch
Attila János Kovács
Péter Andréka
author_facet Csaba Sári
Christian M. Heesch
Attila János Kovács
Péter Andréka
author_sort Csaba Sári
collection DOAJ
description Objective: This study investigates differences based on sex in prognosis for acute coronary syndrome using data of 76,153 patients in Hungary's National Myocardial Infarction Register, focusing on all-cause mortality, risk factors, and treatment outcomes. Methods: The data set analyzed is the result of mandatory reporting on patients presenting with acute coronary syndrome to hospitals in Hungary. The current study comprises a retrospective analysis of all cases reported to the registry from 2014 to 2019. The primary outcome measured was all-cause mortality, with an average follow-up of 3.6 years. Results: The patient cohort had a median age of 67.4 years; females were on average seven years older. Women had a less favorable cardiovascular risk profile, obtained less optimal treatment, experienced more complications, and were less likely to receive guideline-consistent therapy. An age-adjusted analysis demonstrated that age significantly influences risk profiles, types of acute coronary syndrome, treatment strategies, and outcomes. The unadjusted mortality rate for females was significantly higher; however, multivariable analysis indicated that a worse short-term prognosis was contrasted by a better long-term prognosis when comparing females to males. Conclusions: This study highlights the need to further understand and address sex differences in the presentation and management of acute coronary syndrome. The noted higher mortality rates in female patients reveal the necessity for tailored, age-adjusted treatment strategies. Women often present with more advanced cardiovascular risk profiles and face barriers to timely care, making equitable access essential. Understanding the interplay between age, sex, and comorbidities is key to improving patient outcomes.
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spelling doaj-art-c6ea118c7abc46d9b159c742c0cfb2622025-08-20T03:10:47ZengElsevierPreventive Medicine Reports2211-33552025-07-015510313110.1016/j.pmedr.2025.103131Sex-related differences in care and prognosis in acute coronary syndromeCsaba Sári0Christian M. Heesch1Attila János Kovács2Péter Andréka3Gottsegen György National Cardiovascular Center, Budapest, Hungary; Doctoral College of Semmelweis University, Semmelweis University, Budapest, Hungary; Corresponding author at: Department of Cardiovascular Intensive Care, Gottsegen National Cardiovascular Center, 29 Haller Street, 1096, Budapest, Hungary.Gottsegen György National Cardiovascular Center, Budapest, HungaryGottsegen György National Cardiovascular Center, Budapest, HungaryGottsegen György National Cardiovascular Center, Budapest, HungaryObjective: This study investigates differences based on sex in prognosis for acute coronary syndrome using data of 76,153 patients in Hungary's National Myocardial Infarction Register, focusing on all-cause mortality, risk factors, and treatment outcomes. Methods: The data set analyzed is the result of mandatory reporting on patients presenting with acute coronary syndrome to hospitals in Hungary. The current study comprises a retrospective analysis of all cases reported to the registry from 2014 to 2019. The primary outcome measured was all-cause mortality, with an average follow-up of 3.6 years. Results: The patient cohort had a median age of 67.4 years; females were on average seven years older. Women had a less favorable cardiovascular risk profile, obtained less optimal treatment, experienced more complications, and were less likely to receive guideline-consistent therapy. An age-adjusted analysis demonstrated that age significantly influences risk profiles, types of acute coronary syndrome, treatment strategies, and outcomes. The unadjusted mortality rate for females was significantly higher; however, multivariable analysis indicated that a worse short-term prognosis was contrasted by a better long-term prognosis when comparing females to males. Conclusions: This study highlights the need to further understand and address sex differences in the presentation and management of acute coronary syndrome. The noted higher mortality rates in female patients reveal the necessity for tailored, age-adjusted treatment strategies. Women often present with more advanced cardiovascular risk profiles and face barriers to timely care, making equitable access essential. Understanding the interplay between age, sex, and comorbidities is key to improving patient outcomes.http://www.sciencedirect.com/science/article/pii/S2211335525001706Cardiovascular preventionAcute coronary syndromeSex differencesRisk factorsPatient education
spellingShingle Csaba Sári
Christian M. Heesch
Attila János Kovács
Péter Andréka
Sex-related differences in care and prognosis in acute coronary syndrome
Preventive Medicine Reports
Cardiovascular prevention
Acute coronary syndrome
Sex differences
Risk factors
Patient education
title Sex-related differences in care and prognosis in acute coronary syndrome
title_full Sex-related differences in care and prognosis in acute coronary syndrome
title_fullStr Sex-related differences in care and prognosis in acute coronary syndrome
title_full_unstemmed Sex-related differences in care and prognosis in acute coronary syndrome
title_short Sex-related differences in care and prognosis in acute coronary syndrome
title_sort sex related differences in care and prognosis in acute coronary syndrome
topic Cardiovascular prevention
Acute coronary syndrome
Sex differences
Risk factors
Patient education
url http://www.sciencedirect.com/science/article/pii/S2211335525001706
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AT christianmheesch sexrelateddifferencesincareandprognosisinacutecoronarysyndrome
AT attilajanoskovacs sexrelateddifferencesincareandprognosisinacutecoronarysyndrome
AT peterandreka sexrelateddifferencesincareandprognosisinacutecoronarysyndrome