Recent temporal trends in the presentation, management, and outcome of women hospitalized with acute coronary syndromes

Avi Sabbag, Shlomi Matetzky, Shmuel Gottlieb, Paul Fefer, Orly Kohanov, Shaul Atar, Doron Zahger, Avital Porter, Bella Koifman, Ilan Goldenberg, Amit Segev

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background Few data exist on the recent trends in the outcome of women hospitalized with acute coronary syndrome. We examined temporal trends in the hospital management and outcomes of women hospitalized with acute coronary syndrome in a real-world setting. Methods We evaluated time-dependent changes in the clinical characteristics, management strategies, and outcomes of women enrolled in the Acute Coronary Syndrome Israeli Surveys (ACSIS) between 2000 and 2010. Periods were categorized as early (2000-2004) and late (2006-2010). Results Among 11,536 patients enrolled in ACSIS, 2710 (24%) were women. Frequency of women presenting with acute coronary syndrome had declined from 25% in 2000 to 22% in 2010 (P for trend =.002). Women presented less frequently with ST-elevation myocardial infarction and more frequently with associated comorbidities (P <.001 for both). There was no significant reduction in the time delay from symptom onset to emergency department between early and late periods (median: 128 vs 125 minutes; P =.86). This was further reflected in no increase in the frequency of women meeting the goal of door-to-balloon time of ≤90 minutes. The utilization of evidence-based cardiovascular therapies had increased significantly over the past decade (P ;lt001 for all). After multivariate adjustment, admission in the late surveys was associated with a significant reduction in 30-day major adverse cardiac events and 1-year mortality (hazard ratio 0.76; 95% confidence interval, 0.65-0.9, and 0.73; 0.59-0.89, respectively). Conclusions Despite increased frequency of comorbidities and lack of change in time to admission among women hospitalized with acute coronary syndrome, temporal change in management strategies over the last decade may have contributed to improved outcomes in this population.

Original languageEnglish
Pages (from-to)380-388
Number of pages9
JournalAmerican Journal of Medicine
Volume128
Issue number4
DOIs
StatePublished - 1 Apr 2015

Keywords

  • Acute coronary syndrome
  • Gender
  • Outcome
  • Women

ASJC Scopus subject areas

  • Medicine (all)

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