Department of Clinical Medicine, Weill Cornell Medical School, Doha, Qatar.
PLoS One. 2013 Jul 31;8(7):e70066. doi: 10.1371/journal.pone.0070066. Print 2013.
Coronary artery disease (CAD) is the leading cause of mortality worldwide. The present study evaluated the impact of gender in patients hospitalized with acute coronary syndromes (ACS) over a 20-year period in Qatar.
Data were collected retrospectively from the registry of the department of cardiology for all patients admitted with ACS during the study period (1991-2010) and were analyzed according to gender.
Among 16,736 patients who were admitted with ACS, 14262 (85%) were men and 2474 (15%) were women. Cardiovascular risk factors were more prevalent among women in comparison to men. On admission, women presented mainly with non-ST-elevation ACS and were more likely to be undertreated with β-blockers (BB), antiplatelet agents and reperfusion therapy in comparison to men. However, from 1999 through 2010, the use of aspirin, angiotensin-converting enzyme inhibitors and BB increased from 66% to 79%, 27% to 41% and 17% to 49%, respectively in women. In the same period, relative risk reduction for mortality was 64% in women and 51% in men. Across the 20-year period, the mortality rate decreased from 27% to 7% among the Middle Eastern Arab women. Multivariate logistic regression analysis showed that female gender was independent predictor of in-hospital mortality (odd ratio 1.51, 95% CI 1.27-1.79).
Women presenting with ACS are high-risk population and their in-hospital mortality remains higher for all age groups in comparison to men. Although, substantial improvement in the hospital outcome has been observed, guidelines adherence and improvement in the hospital care have not yet been optimized.
冠心病（CAD）是全球范围内导致死亡的主要原因。本研究评估了 20 年来卡塔尔急性冠状动脉综合征（ACS）住院患者的性别影响。
从心内科登记处收集了研究期间（1991-2010 年）所有因 ACS 住院的患者数据，并根据性别进行了分析。
在 16736 例因 ACS 住院的患者中，14262 例（85%）为男性，2474 例（15%）为女性。与男性相比，女性心血管危险因素更为常见。入院时，女性主要表现为非 ST 段抬高型 ACS，与男性相比，β受体阻滞剂（BB）、抗血小板药物和再灌注治疗的使用率较低。然而，从 1999 年到 2010 年，女性阿司匹林、血管紧张素转换酶抑制剂和 BB 的使用率分别从 66%增加到 79%、27%增加到 41%和 17%增加到 49%。在此期间，女性的死亡率相对风险降低了 64%，男性降低了 51%。在 20 年期间，中东阿拉伯女性的死亡率从 27%降至 7%。多变量逻辑回归分析表明，女性性别是院内死亡率的独立预测因素（比值比 1.51，95%置信区间 1.27-1.79）。
患有 ACS 的女性是高危人群，与男性相比，所有年龄段的女性住院死亡率仍然较高。尽管观察到医院治疗结果的显著改善，但指南的依从性和医院护理的改善尚未得到优化。
