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

Authors
 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 
Citation
 YONSEI MEDICAL JOURNAL, Vol.52(4) : 562-568, 2011 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2011
MeSH
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
Keywords
Acute coronary syndrome, gender identity, Korea, prognosis
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.
Files in This Item:
T201194508.pdf Download
DOI
10.3349/ymj.2011.52.4.562
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Kwang Joon(김광준) ORCID logo https://orcid.org/0000-0002-5554-8255
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Bang, Woo Dae(방우대)
Oh, Chang Myung(오창명)
Yu, Hee Tae(유희태) ORCID logo https://orcid.org/0000-0002-6835-4759
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Jang Ji Yong(장지용)
Cho, Sung Soo(조성수)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/158214
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