Gender Differences in the Treatment and Outcomes of Patients With ACSs

Kunadian, V., Qiu, W., Bawamia, B., Veerasamy, M., Jamieson, S., & Zaman, A. (2013). Gender comparisons in cardiogenic shock during ST elevation myocardial infarction treated with primary percutaneous coronary intervention. The American Journal of Cardiology, 112(5), 636-641.

The research compares the gender intervention toward the hospitalized patients with acute myocardial infarction and cardiogenic shock. The scope of the study was to determine the outcome of using percutaneous coronary intervention (PCI) in the management of cardiogenic shock between male and female. The research was conducted at Freeman Hospital, United Kingdom in 2011. The research involved determination of cardiogenic shock through systolic blood pressure measurements of the hospitalized patients. Patients presenting with chest pain symptoms were subjected to primary percutaneous coronary intervention. According to the study findings, there is no gender difference in the presentation of the cardiogenic shock and myocardial infarction. Additionally, the study observed that the mean age of men and women visiting the hospital presenting with chest pain and myocardial infarction were between 64 and 70 years. A shortcoming of the study is a single hospital conduction of the research with minimal medical history of the patients under the study. The study was biased to patients that underwent primary percutaneous coronary intervention, hence leading to limited data. The authors conclude that there is no gender difference in the presentation of chest pain symptoms that have relation with cardiogenic shock and myocardial infarction. The research supports the advanced management of patients presenting with chest pain symptoms in order to decrease the mortality rate of patients due to cardiogenic shock.

Panagiotakos, D. B., Pitsavos, C., Kourlaba, G., Mantas, Y., Zombolos, S., Kogias, Y., Antonoulas, A., Stravopodis, P. & Stefanadis, C. (2007). Sex-related characteristics in hospitalized patients with acute coronary syndromesthe Greek Study of Acute Coronary Syndromes (GREECS). Heart and vessels, 22(1), 9-15.

The research is specific to the sex-related factors that contribute to hospitalization of the patients presenting with acute coronary syndromes in Greece. The study compares male and female patients with acute coronary syndromes and other clinical characteristics in relation to the outcome of the treatment. The research was conducted in rural and urban hospitals in Greece between 2003 and 2004. The study enrolled male and female patients that presented with acute coronary syndromes and other sociodemographic prevalent risk factors, such as diet. In addition, the study compared the sex-related incidence and mortality rates of acute coronary syndromes in the hospitals. The authors found that the females have a higher incidence and mortality rate than males. The major presenting symptoms for males are Q-wave myocardial infarctions, while for females chest pains. Females have higher records of medical history of obesity, diabetes and hypertension than males. The shortcomings of the study are the lack of representation of the total cases presenting with acute coronary syndrome and exclusion of mortality records of the previous records. The authors conclude that the sex-related differences have relations to the clinical presentations and cardiovascular risks in the hospitalized patients with acute coronary syndromes. The research provides gaps for further research on management of acute coronary syndromes among the hospitalized patients in Greece. Additionally, lifestyle habits contribute to the higher mortality rate of women compared to men presenting with acute coronary syndromes.

Poon, S., Goodman, S. G., Yan, R. T., Bugiardini, R., Bierman, A. S., Eagle, K. A., Johnston, N., Huynh, T., Grondin, F. R., Schenck-Gustafsson, K. & Yan, A. T. (2012). Bridging the gender gap: Insights from a contemporary analysis of sex-related differences in the treatment and outcomes of patients with acute coronary syndromes. American heart journal, 163(1), 66-73.

The research addresses the difference in treatment between male and female presenting with acute coronary syndromes. The scope of the study involved collection of the data registries for determining the rationale for differences in conservative management of the acute coronary syndromes between men and women. The research was conducted in Canada, where the authors recruited 14,196 patients presenting with acute coronary syndromes. The authors grouped the study subjects into four registries for follow-up studies. The significance of the study is the identification of the variations of medical history between males and females and relating them to the acute coronary syndromes. The clinical symptoms between male and female also vary, leading to variations in treatment. The use of the registries in conducting scientific research has a high likelihood of selection bias and consecutive enrollment. Additionally, the study found difficulties in the verification of the registry leading to limitations in the credibility of the research results. The authors concluded that women receive more of conservative treatment than their counterpart men. The physicians underestimate the patients risks leading to high gender gap based treatment. In summary, the study creates awareness of the existence of variations in treatment and potential risks in the management of acute coronary syndromes.

Shehab, A., Al-Dabbagh, B., AlHabib, K. F., Alsheikh-Ali, A. A., Almahmeed, W., Sulaiman, K., Al-Motarreb, A., Nagelkerke, N., Al Suwaidi, J. & Amin, H. (2013). Gender disparities in the presentation, management and outcomes of acute coronary syndrome patients: data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2). PloS one, 8(2), e55508.

The study uses the 2^nd Gulf registry in the determination of gender-related difference in the mortality records due to acute coronary syndrome. The scope of the study involved determination of the clinical presentations, treatment patterns, and mortality records due to acute coronary syndrome in the Middle-East countries. The study used data from patients above 18 years. The patients involved in the study were those who were hospitalized and whose final diagnosis was acute coronary syndrome. Follow-up of the patients was conducted under the supervision of a cardiologist in order to collect the outcome parameters during diagnosis of acute coronary syndromes. The results of the study aimed at understanding the underlying pathology difference between male and female presenting with acute coronary syndromes. The study found that mortality rate due to acute coronary syndrome was higher in women than men due to differences in management. The limitations of the study were the lack of confounders that were likely to influence the results and the presence of bias in the findings due to missing information after the discharge of patients. In conclusion, women with acute coronary syndromes have a high rate of mortality due to associated risks such as hypertension, hyperlipidemia, and diabetes. There is much disparity in outcomes of treatment between men and women presenting with acute coronary syndromes due to underestimation of patient risk and medical management.

References

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