PMID- 32563689 OWN - NLM STAT- MEDLINE DCOM- 20210215 LR - 20210215 IS - 1879-0828 (Electronic) IS - 0953-6205 (Linking) VI - 81 DP - 2020 Nov TI - Sex-related differences in long-term mortality and heart failure in a contemporary cohort of patients with NSTEACS. The cardiochus-HSUJ registry. PG - 26-31 LID - S0953-6205(20)30249-1 [pii] LID - 10.1016/j.ejim.2020.06.011 [doi] AB - INTRODUCTION AND OBJECTIVES: There is insufficient data regarding sex-related prognostic differences in patients with a non-ST elevation acute coronary syndrome (NSTEACS). We performed a sex-specific analysis of cardiovascular outcomes after NSTEACS using a large contemporary cohort of patients from two tertiary hospitals. METHODS: This work is a retrospective analysis from a prospective registry, that included 5,686 consecutive NSTEACS patients from two Spanish University hospitals between the years 2005 and 2017. We performed a propensity score matching to obtain a well-balanced subset of individuals with the same clinical characteristics, resulting in 3,120 patients. Cox regression models performed survival analyses once the proportional risk test was verified. RESULTS: Among the study participants, 1,572 patients (27.6%) were women. The mean follow-up was 60.0 months (standard deviation of 32 months). Women had a higher risk of cardiovascular mortality compared with men (OR (Odds ratio) 1.27, CI (confidence interval) 95% 1.08-1.49), heart failure (HF) hospitalization (OR 1.39, CI 95% 1.18-1.63) and risk of all-cause mortality (OR 1.10, CI 95% 1.08-1.49). After a propensity score matching, female gender was associated with a significant reduction in the risk of total mortality (OR 0.77, CI 95% 0.65-0.90) with a similar risk of cardiovascular mortality (OR 0.86, CI 0.71-1.03) and HF hospitalization (OR 0.92, CI 95% 0.68-1.23). After baseline adjustment, the risk of all-cause mortality and cardiovascular mortality was lower in women, whereas the risk of HF remained similar among sexes. CONCLUSIONS: In a contemporary cohort of patients with NSTEACS, women are at similar risk of developing early and late HF admissions, and have better survival compared with men, with a lower risk of all-cause mortality and cardiovascular mortality. The implementation of NSTEACS guideline recommendations in women, including early revascularization, seems to be accompanied by improved early and long-term prognosis. CI - Copyright (c) 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved. FAU - Alvarez Alvarez, Belen AU - Alvarez Alvarez B AD - Cardiology Department. Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV). Electronic address: belenalvarez85@hotmail.com. FAU - Abou Jokh Casas, Charigan AU - Abou Jokh Casas C AD - Cardiology Department. Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV). FAU - Agra Bermejo, Rosa AU - Agra Bermejo R AD - Cardiology Department. Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV). FAU - Cordero, Alberto AU - Cordero A AD - Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV); Cardiology Department. Hospital Universitario de San Juan. Alicante, Spain. FAU - Cid Alvarez, Ana Belen AU - Cid Alvarez AB AD - Cardiology Department. Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV). FAU - Rodriguez Manero, Moises AU - Rodriguez Manero M AD - Cardiology Department. Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV). FAU - Bouzas Cruz, Noelia AU - Bouzas Cruz N AD - Cardiology Department. Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV). FAU - Garcia Acuna, Jose Maria AU - Garcia Acuna JM AD - Cardiology Department. Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV). FAU - Salgado Barreiro, Angel AU - Salgado Barreiro A AD - Methodology and Statistics unit. IDIS SUR. Vigo, Spain. FAU - Gonzalez-Juanatey, Jose R AU - Gonzalez-Juanatey JR AD - Cardiology Department. Complejo Hospitalario Universitario de Santiago de Compostela. Santiago de Compostela, Spain; Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV). LA - eng PT - Journal Article DEP - 20200618 PL - Netherlands TA - Eur J Intern Med JT - European journal of internal medicine JID - 9003220 SB - IM CIN - Eur J Intern Med. 2020 Nov;81:24-25. PMID: 32883571 MH - *Acute Coronary Syndrome MH - Cohort Studies MH - Female MH - *Heart Failure MH - Humans MH - Male MH - Registries MH - Retrospective Studies MH - Risk Factors EDAT- 2020/06/22 06:00 MHDA- 2021/02/16 06:00 CRDT- 2020/06/22 06:00 PHST- 2020/04/02 00:00 [received] PHST- 2020/05/31 00:00 [revised] PHST- 2020/06/10 00:00 [accepted] PHST- 2020/06/22 06:00 [pubmed] PHST- 2021/02/16 06:00 [medline] PHST- 2020/06/22 06:00 [entrez] AID - S0953-6205(20)30249-1 [pii] AID - 10.1016/j.ejim.2020.06.011 [doi] PST - ppublish SO - Eur J Intern Med. 2020 Nov;81:26-31. doi: 10.1016/j.ejim.2020.06.011. Epub 2020 Jun 18.