Yonsei Med J.  2011 Jul;52(4):562-568. 10.3349/ymj.2011.52.4.562.

Gender-Based Differences in the Management and Prognosis of Acute Coronary Syndrome in Korea

• Yu HT
• Kim KJ
• Bang WD
• Oh CM
• Jang JY
• Cho SS
• Kim JS
• Ko YG
• Choi D
• Hong MK
• Jang Y

• KMID: 1727986
• DOI: http://doi.org/10.3349/ymj.2011.52.4.562

Abstract

PURPOSE
Gender-based differences exist in the characteristics, management, and prognosis of acute coronary syndrome (ACS). However, their impact on prognosis remains unclear. We aimed to identify factors causing these differences in Koreans.
MATERIALS AND METHODS
We examined 6,636 ACS patients (66.2% males) visiting 72 Korean hospitals between April-2007 and December-2008. Gender-based differences in clinical demographics, therapy, and outcomes were analyzed over 6 months.
RESULTS
Women were older than men [mean (standard deviation, SD) age, 67.6 (9.8) vs. 60.6 (11.2) years; p<0.001]; had higher rates of hypertension, diabetes mellitus, and lack of exercise (p<0.001 for all); and lower rates of obesity, familial history of cardiovascular disease (CVD), and smoking (p<0.05 for all). Atypical symptoms were more common in women (20.5% vs. 15.1% in men, p<0.001), whereas myocardial infarction with ST-segment elevation was less common (17.1% vs. 27.8%, p<0.001). Mean (SD) time lapse from symptom onset to arrival at hospital was longer in women [11.44 (18.19) vs. 8.26 (14.89) hours in men, p<0.001], as was the duration of hospitalization [7.58 (7.61) vs. 7.04 (7.72) days, p=0.007]. Fewer women underwent revascularization procedures, including thrombolytic therapy, balloon angioplasty, stent implantation, and coronary artery bypass grafting (79.4% vs. 83.3% men, p<0.001). No significant differences were observed in CVD-related death, recurrent ACS, stroke, refractory angina, or rehospitalization for angina.
CONCLUSION
Female ACS patients were older than male subjects and had more atypical presentation. They arrived at the hospital later than men and had longer hospital stays, but less often required revascularization therapy. However, no gender-based differences were noted in ACS-related mortality and morbidity.

Keyword

Acute coronary syndrome; gender identity; Korea; prognosis; introduction

MeSH Terms

Acute Coronary Syndrome/complications/*diagnosis/therapy
Adult
Age Factors
Aged
Female
Humans
Male
Middle Aged
Prognosis
Prospective Studies
Republic of Korea
Sex Factors

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