Rocamora-Horrach Mar, Peiró Óscar M, Bardají Alfredo, Flores-Benítez Javier, Ivorra-Cámara Miguel, Carrasquer Anna, Ferreiro José Luis
Department of Cardiology, Joan XXIII University Hospital, Tarragona, Spain.
Pere Virgili Health Research Institute, Rovira i Virgili University, Tarragona, Spain.
Front Cardiovasc Med. 2024 Aug 23;11:1447533. doi: 10.3389/fcvm.2024.1447533. eCollection 2024.
Cardiovascular disease has traditionally been studied predominantly in men, but understanding its manifestations in women is crucial for effective management. This study aims to evaluate the long-term prognosis of female patients with acute coronary syndrome (ACS) within a tertiary hospital setting in Spain.
Retrospective observational study based on a cohort of consecutive hospitalized patients with ACS from January 2009 to December 2014. Data on demographics, risk factors, treatment, and outcomes were collected, with a median follow-up of 9.2 years.
Women with ACS, constituting 27.3% of 2,330 patients, were older and had a higher prevalence of cardiovascular risk factors such as obesity, hypertension, and diabetes mellitus compared to men. They presented with more non-ST-segment elevation myocardial infarction and underwent less coronary angiography. Female patients were also less likely to be treated with acetylsalicylic acid, a second antiplatelet drug, or statins. Despite initial higher mortality rates [hazard ratio (HR) 1.30; 95% confidence interval (CI) 1.13-1.49; < 0.001], female patients exhibited a more favorable long-term prognosis after adjustments (adjusted HR 0.82; 95% CI 0.71-0.96; = 0.014), even in the subgroup analysis excluding patients with unstable angina.
Women with ACS are more comorbid, but after adjustments, female sex appears to be a protective factor that confers a better long-term prognosis.
传统上，心血管疾病主要在男性中进行研究，但了解其在女性中的表现对于有效管理至关重要。本研究旨在评估西班牙一家三级医院中急性冠状动脉综合征（ACS）女性患者的长期预后。
基于2009年1月至2014年12月连续住院的ACS患者队列进行回顾性观察研究。收集了人口统计学、危险因素、治疗和结局数据，中位随访时间为9.2年。
ACS女性患者占2330例患者的27.3%，与男性相比，年龄更大，肥胖、高血压和糖尿病等心血管危险因素的患病率更高。她们表现为更多的非ST段抬高型心肌梗死，接受冠状动脉造影的比例更低。女性患者接受阿司匹林、第二种抗血小板药物或他汀类药物治疗的可能性也较小。尽管初始死亡率较高[风险比（HR）1.30；95%置信区间（CI）1.13 - 1.49；P < 0.001]，但调整后女性患者显示出更有利的长期预后（调整后HR 0.82；95% CI 0.71 - 0.96；P = 0.014），即使在排除不稳定型心绞痛患者的亚组分析中也是如此。
ACS女性患者合并症更多，但调整后，女性性别似乎是一个保护因素，可带来更好的长期预后。
