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Gender-based differences in the management and prognosis of acute coronary syndrome in Korea

 Hee Tae Yu  ;  Kwang Joon Kim  ;  Woo-Dae Bang  ;  Chang-Myung Oh  ;  Ji-Yong Jang  ;  Sung-Soo Cho  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang 
 Yonsei Medical Journal, Vol.52(4) : 562-568, 2011 
Journal Title
 Yonsei Medical Journal 
Issue Date
Acute Coronary Syndrome/complications ; Acute Coronary Syndrome/diagnosis* ; Acute Coronary Syndrome/therapy ; Adult ; Age Factors ; Aged ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Republic of Korea ; Sex Factors
Acute coronary syndrome, gender identity, Korea, prognosis
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
고영국(Ko, Young Guk) ORCID logo https://orcid.org/0000-0001-7748-5788
김광준(Kim, Kwang Joon) ORCID logo https://orcid.org/0000-0002-5554-8255
김중선(Kim, Jung Sun) ORCID logo https://orcid.org/0000-0003-2263-3274
방우대(Bang, Woo Dae)
오창명(Oh, Chang Myung)
유희태(Yu, Hee Tae) ORCID logo https://orcid.org/0000-0002-6835-4759
장양수(Jang, Yang Soo) ORCID logo https://orcid.org/0000-0002-2169-3112
장지용(Jang Ji Yong)
조성수(Cho, Sung Soo)
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
홍명기(Hong, Myeong Ki) ORCID logo https://orcid.org/0000-0002-2090-2031
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