急性冠状动脉综合征的临床表现中的性别差异。

Sex Differences in the Clinical Presentation of Acute Coronary Syndromes.

机构信息

Department of Cardiology, Hospital de Alta Complejidad El Cruce, Florencio Varela, Buenos Aires. Argentina; GEDIC, Grupo de Estudio, Docencia e Investigación Clínica, Buenos Aires, Argentina.

Department of Cardiology, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina; Department of Internal Medicine, Instituto Alexander Fleming, Buenos Aires, Argentina.

出版信息

Curr Probl Cardiol. 2022 Oct;47(10):101300. doi: 10.1016/j.cpcardiol.2022.101300. Epub 2022 Jun 24.

DOI:10.1016/j.cpcardiol.2022.101300

PMID:35760149

Abstract

The clinical presentation of acute coronary syndromes (ACS) as ST-elevation ACS (STEACS) or non-ST-elevation ACS (NSTEACS) differs between women and men. The aim of this study was to describe the difference in the clinical presentation of ACS between sexes. A total of 10,019 patients included in the Epi-Cardio Registry were analyzed. A higher proportion of women than men presented with NSTEACS (60.3% vs 46.7%; P <0.001). The difference between sexes was driven by a higher prevalence of ACS with non-obstructive coronary arteries (20.9% vs 6.6%) mainly in young women, since ACS without coronary lesions were mostly NSTEACS (77.7% vs 22.3%). In patients with obstructive coronary heart disease, there were no differences in the clinical presentation between sexes. In conclusion, younger women are more likely than men to present ACS with non-obstructive coronary arteries, whereas no significant difference exists between sexes regarding the prevalence of ACS with obstructive coronary artery disease.

摘要

急性冠状动脉综合征（ACS）的临床表现分为 ST 段抬高型 ACS（STEACS）和非 ST 段抬高型 ACS（NSTEACS），女性和男性之间存在差异。本研究旨在描述 ACS 临床表现的性别差异。共分析了 Epi-Cardio 注册中心纳入的 10019 例患者。与男性相比，女性中 NSTEACS 的比例更高（60.3%比 46.7%；P<0.001）。这种性别差异是由于非阻塞性冠状动脉疾病所致 ACS 的发生率更高（20.9%比 6.6%），主要是在年轻女性中，因为无冠状动脉病变的 ACS 大多为 NSTEACS（77.7%比 22.3%）。在阻塞性冠心病患者中，男女之间的临床表现无差异。总之，年轻女性比男性更有可能出现非阻塞性冠状动脉所致 ACS，而在阻塞性冠状动脉疾病所致 ACS 的患病率方面，男女之间没有显著差异。