Sex-gender disparities in nonagenarians with acute coronary syndrome
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- dc.contributor.author Cepas-Guillen, Pedro L.
- dc.contributor.author Echarte-Morales, Julio
- dc.contributor.author Flores-Umanzor, Eduardo
- dc.contributor.author Fernandez-Valledor, Andrea
- dc.contributor.author Caldentey, Guillem
- dc.contributor.author Viana-Tejedor, Ana
- dc.contributor.author Martinez Gomez, Eduardo
- dc.contributor.author Tundidor-Sanz, Elena
- dc.contributor.author Borrego-Rodriguez, Javier
- dc.contributor.author Vidal, Pablo
- dc.contributor.author Llagostera Martín, Marc
- dc.contributor.author Quiroga Arbones, Xavier
- dc.contributor.author Freixa, Xavier
- dc.contributor.author Fernández-Vázquez, Felipe
- dc.contributor.author Sabaté, Manel
- dc.date.accessioned 2021-06-14T07:40:22Z
- dc.date.available 2021-06-14T07:40:22Z
- dc.date.issued 2021
- dc.description.abstract Background: Acute coronary syndrome (ACS) remains one of the leading causes of mortality for women, increasing with age. There is an unmet need regarding this condition in a fast-growing and predominantly female population, such as nonagenarians. Hypothesis: Our aim is to compare sex-based differences in ACS management and long-term clinical outcomes between women and men in a cohort of nonagenarians. Methods: We included consecutive nonagenarian patients with ACS admitted at four academic centers between 2005 and 2018. The study was approved by the Ethics Committee of each center. Results: A total of 680 nonagenarians were included (59% females). Of them, 373 (55%) patients presented with non-ST-segment elevation ACS and 307 (45%) with ST-segment elevation myocardial infarction (STEMI). Men presented a higher disease burden compared to women. Conversely, women were frailer with higher disability and severe cognitive impairment. In the STEMI group, women were less likely than men to undergo percutaneous coronary intervention (PCI) (60% vs. 45%; p = .01). Overall mortality rates were similar in both groups but PCI survival benefit at 1-year was greater in women compared to their male counterparts (82% vs. 68%; p = .008), persisting after sensitivity analyses using propensity-score matching (80% vs. 64%; p = .03). Conclusion: Sex-gender disparities have been observed in nonagenarians. Despite receiving less often invasive approaches, women showed better clinical outcomes. Our finding may help increase awareness and reduce the current gender gap in ACS management at any age.
- dc.format.mimetype application/pdf
- dc.identifier.citation Cepas-Guillen PL, Echarte-Morales J, Flores-Umanzor E, Fernandez-Valledor A, Caldentey G, Viana-Tejedor A, et al. Sex-gender disparities in nonagenarians with acute coronary syndrome. Clin Cardiol. 2021 Mar;44(3): 371-8. DOI: 10.1002/clc.23545
- dc.identifier.doi http://dx.doi.org/10.1002/clc.23545
- dc.identifier.issn 0160-9289
- dc.identifier.uri http://hdl.handle.net/10230/47861
- dc.language.iso eng
- dc.publisher Wiley
- dc.rights Copyright © 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword ST-segment elevation myocardial infarction
- dc.subject.keyword Acute coronary syndrome
- dc.subject.keyword Elderly
- dc.subject.keyword Myocardial infarction
- dc.subject.keyword Women
- dc.title Sex-gender disparities in nonagenarians with acute coronary syndrome
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion