Clinical ResearchSex Differences in Clinical Outcomes After Premature Acute Coronary Syndrome
Section snippets
Study design and population
We used data from Gender and Sex Determinants of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary Syndrome (GENESIS-PRAXY), a multicentre prospective cohort study of patients hospitalized for premature ACS. See Supplemental Appendix S2 for the list of participating centers. Eligible patients were adults between 18 and 55 years who were fluent in English or French, able to provide informed consent, and admitted to the hospital with a confirmed diagnosis of ACS. Eligible
Patient characteristics
Our study included 1163 patients with complete follow-up data from chart reviews at 12 months, representing 96% of the 1213 patients enrolled at baseline. Our cohort was composed of 67% (783) men and 33% (380) women, with both having the same median age (Table 1). Participation refusal rates among eligible patients were 18% in men and 10% in women.
The prevalence of cardiovascular risk factors was generally greater in women than in men. Specifically, women had a higher prevalence of hypertension
Discussion
In our cohort of patients with premature ACS, men and women faced a high, yet similar, likelihood of MACE within the 12 months after the index event. Women did not have an increased risk of mortality compared with men, and the overall mortality rate was low. In contrast, women were overall more likely than men to be rehospitalized after premature ACS, but this difference was not present when looking at cardiac-related rehospitalization specifically. In both sexes, the majority of first
Conclusions
In this cohort of patients with premature ACS, we found a low mortality rate but a high rate of MACE and rehospitalization considering the young age of our cohort. Furthermore, women were more likely to be rehospitalized, yet they had outcomes similar to those of men.
Acknowledgements
We would like to thank Jasmine Poole for coordinating the study, Hassan Behlouli for statistical analyses, the GENESIS-PRAXY site investigators, and all the participants in GENESIS-PRAXY for their invaluable contribution to this research.
Funding Sources
L.P. holds a James McGill Chair at McGill University. GENESIS-PRAXY is funded by the Canadian Institutes of Health Research and Heart and Stroke Foundations of Alberta, NWT & Nunavut, British Columbia and Yukon, Nova Scotia, Ontario, and Québec.
Disclosures
The authors have no conflicts of interest to disclose.
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2022, American Journal of CardiologyCitation Excerpt :However, other investigations, such as the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), reported similar mortality in nonobstructive disease compared with obstructive disease.21 This study did not find differences in in-hospital mortality between men and women, similar to the results of the largest prospective gender-gap studies in younger patients, the VIRGO and the GENESIS-PRAXY studies.13 In-hospital mortality was 3.4% in men and 2% in women.
See editorial by Sedlak and Izadnegahdar, pages 1375–1377 of this issue.
See page 1452 for disclosure information.
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See Supplemental Appendix S1 for a list of coinvestigators for GENESIS-PRAXY.