Síndrome coronario agudo en la mujer. Diferencias de género / Acute coronary syndrome in women. Gender differences

Fundamento y objetivo: Analizar si hay indicios de diferencias por género en el diagnóstico, tratamiento y pronóstico de los pacientes ingresados con síndrome coronario agudo (SCA). Pacientes y método: Estudio prospectivo de una cohorte de 396 pacientes que ingresaron a lo largo de un período de 18 meses en una unidad coronaria con el diagnóstico de SCA. Se dividió a los pacientes en dos grupos en función del género (294 varones y 102 mujeres). Se analizaron las medidas diagnósticas, el tratamiento hospitalario, la revascularización coronaria (ICP), la aparición de insuficiencia cardíaca (IC) y la mortalidad intrahospitalaria y al año. Resultados: La edad media (±DE) de las mujeres fue mayor (70,9±11,9 frente al 64,4±12,0 años; p<0,001) y presentaron más comorbilidades, tales como hipertensión (70,5% frente al 53,7%; p<0,01), diabetes (51,0% frente al 33,3%; p<0,01) e IC previa (20,5% frente al 9,1%; p<0,01) que los varones, mientras que estos presentaron mayor frecuencia de tabaquismo (54,4% frente al 13,7%; p<0,001). Las mujeres presentaron mayor incidencia de shock cardiogénico al ingreso. No hubo diferencias entre ambos sexos en el tratamiento trombolítico, ni en el patrón de acceso a la angiografía coronaria, pero los varones presentaron mayor frecuencia de ICP con éxito (50,8% frente al 34,6%; p<0,01). Las mujeres presentaron con más frecuencia IC intrahospitalaria (32,6% frente al 25,9%; p<0,05) y muerte intrahospitalaria (17,6% frente al 4,7%; p<0,001). En el análisis multivariante, la insuficiencia cardíaca al ingreso (odds ratio [OR]: 8,98; intervalo de confianza del 95% [IC 95%]: 3,29-24,47), la mayor edad (OR: 1,07; IC 95%: 1,01-1,13) y el género femenino (OR: 3,14; IC 95%: 1,27-7,74) fueron predictores independientes de mortalidad hospitalaria.Conclusiones: En nuestro estudio, el género femenino fue un predictor independiente de mortalidad hospitalaria en pacientes con SCA (AU)

Background and objective: Our aims was to investigate possible gender differences in the diagnostic assessment, treatment and prognosis of patients admitted with acute coronary syndrome (ACS).Patients and methods: Prospective study of a cohort of 396 patients consecutively admitted to the coronary unit in the period of 18 months with the diagnoses of ACS. We divided the sample into two groups based on gender: 294 men and 102 women. We analysed the diagnostic assessment, hospital treatment, coronary revascularization (ICP), appearance of heart failure (HF) and in-hospital and 1-year mortality. We analyzed predictors of mortality in a multivariate model. Results:Women were older (70.9±11.9 versus 64.4±12.0; P<.001) and had more comorbidities such as hypertension (70.5% versus 53.7%; P=.003), diabetes (51.0% versus 33.3%; P<.01) and HF (20.5% versus 9.1%; P<.01) than men, while men had greater frequency of smoking (54.42% versus 13.73%; P<.001). Women had higher incidence of cardiogenic shock on admission. There were no differences in thrombolysis and women did not have a different pattern of access to coronary angiography, but men had greater frequency of ICP (50.8% versus 34.6%; P<.01). Women were more likely to develop a higher in-hospital HF (32.6% versus 25.9%; P<.05) and in-hospital mortality (17.6% versus 4.7%; P<.001). In the multivariate analyses, HF on admission OR 8.98 (3.29-24.47), older age OR 1.07 (1.01-1.13) and female gender OR 3.14 (1.27-7.74), were independent predictors of in-hospital mortality.Conclusions: In our study, female gender was an independent predictor of in-hospital mortality in patients with ACS (AU)

[Acute coronary syndrome in women. Gender differences]. / Síndrome coronario agudo en la mujer. Diferencias de género.

BACKGROUND AND OBJECTIVE: Our aims was to investigate possible gender differences in the diagnostic assessment, treatment and prognosis of patients admitted with acute coronary syndrome (ACS). PATIENTS AND METHODS: Prospective study of a cohort of 396 patients consecutively admitted to the coronary unit in the period of 18 months with the diagnoses of ACS. We divided the sample into two groups based on gender: 294 men and 102 women. We analysed the diagnostic assessment, hospital treatment, coronary revascularization (ICP), appearance of heart failure (HF) and in-hospital and 1-year mortality. We analyzed predictors of mortality in a multivariate model. RESULTS: Women were older (70.9±11.9 versus 64.4±12.0; P<.001) and had more comorbidities such as hypertension (70.5% versus 53.7%; P=.003), diabetes (51.0% versus 33.3%; P<.01) and HF (20.5% versus 9.1%; P<.01) than men, while men had greater frequency of smoking (54.42% versus 13.73%; P<.001). Women had higher incidence of cardiogenic shock on admission. There were no differences in thrombolysis and women did not have a different pattern of access to coronary angiography, but men had greater frequency of ICP (50.8% versus 34.6%; P<.01). Women were more likely to develop a higher in-hospital HF (32.6% versus 25.9%; P<.05) and in-hospital mortality (17.6% versus 4.7%; P<.001). In the multivariate analyses, HF on admission OR 8.98 (3.29-24.47), older age OR 1.07 (1.01-1.13) and female gender OR 3.14 (1.27-7.74), were independent predictors of in-hospital mortality. CONCLUSIONS: In our study, female gender was an independent predictor of in-hospital mortality in patients with ACS.

Proteína C activada en malaria grave por Plasmodium falciparum / Activated protein C in severe plasmodium falciparum malaria

No disponible