Gender Differences among Patients with Acute Coronary Syndrome in the Middle East

• Published in: Heart views Vol. 18; no. 3; pp. 77 - 82
• Main Authors: Khesroh, Aliah Ali, Al-Roumi, Faisal, Al-Zakwani, Ibrahim, Attur, Sreeja, Rashed, Wafa, Zubaid, Mohammad
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.07.2017; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Acute coronary syndrome; Acute coronary syndromes; Angina pectoris; Arabian Gulf; Cardiovascular disease; Care and treatment; Catheterization; Chi-square tests; Coronary artery bypass; Coronary heart disease; Diabetes; Diagnosis; Family medical history; gender; Gender differences; Heart attacks; Heart failure; Hospitals; Hypertension; Medicine; Mens health; Middle East; Mortality; Original; registries; Sex differences (Biology); Womens health; Middle East; Oman; Middle East; registries; gender; Acute coronary syndrome; Arabian Gulf
• ISSN: 1995-705X; 0976-5123
• DOI: 10.4103/HEARTVIEWS.HEARTVIEWS_10_17

There is controversy regarding the relationship between gender and acute coronary syndrome (ACS). To study the impact of gender on presentation, management, and mortality among patients with ACS in the Middle East. From January 2012 to January 2013, 4057 patients with ACS were enrolled from four Arabian Gulf countries (Kuwait, Oman, United Arab Emirates, and Qatar), representing more than 85% of the general hospitals in each of the participating countries. Compared to men, women were older and had more comorbidities. They also had atypical presentation of ACS such as atypical chest pain and heart failure. The prevalence of non-ST-segment elevation myocardial infarction (49 vs. 46%; < 0.001) and unstable angina (34 vs. 24%; < 0.001) was higher among women as compared to men. In addition, women were less likely to receive evidence-based medications such as aspirin, clopidogrel, beta-blocker, and angiotensin-converting enzyme inhibitors on admission and on discharge. During hospital stay, women suffered more heart failure (15 vs. 12%; = 0.008) and were more likely to receive blood transfusion (6 vs. 3%; < 0.001). Women had higher 1-year mortality (14 vs. 11%; < 0.001), the apparent difference that disappeared after adjusting for age and other comorbidities. Although there were differences between men and women in presentation, management, and in-hospital outcomes, gender was shown to be a nonsignificant contributor to mortality after adjusting for confounders.