According to a new study published in Canadian Journal of Cardiology, young patients with acute coronary syndrome (ACS) have a good 1-year prognosis, regardless of their gender.

Previous studies had found that women who suffer from ACS have a poorer prognosis when compared to their male counterparts. Young women were found to be more likely than men to die from a cardiac-related event in the 12 months after hospital discharge.

Coronary heart disease has been steadily decreasing over the past few decades, but premature ACS remains to be a significant cause of morbidity and mortality worldwide.

In the new study, researchers used data from GENESIS-PRAXY (Gender and Sex Determinants of Cardiovascular Disease from Bench to Beyond in Premature Acute Coronary Syndrome), a multicenter prospective cohort study of patients hospitalized for ACS. The study gathered contemporary data from 26 different hospitals.


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Eligible patients for this study were adults aged 18 to 55 who had been recently admitted to a hospital with a confirmed diagnosis of ACS. Study researchers documented 2 types of adverse clinical outcomes: major adverse cardiovascular events (MACE) and death, either all-cause or cardiac-related. Events characterized as a MACE included an occurrence of recurrent ACS, a need for percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) surgery or cardiac-related mortality.

According to Roxanne Pelletier, PhD, and colleagues, similar rates of major adverse cardiac events, death and cardiac-related rehospitalization were seen in both men and women in the year following hospitalization for premature ACS. In addition, chest pain and angina were the most common reasons for rehospitalization for both men and women.

Although women were more likely than men to be rehospitalized for all causes after premature ACS, overall, this was not the case when looking specifically at cardiac-related rehospitalizations. Both men and women had a similar likelihood of MACE within the 12 months following the initial ACS event.

Researchers concluded that women did not have an increased risk of mortality when compared to men, both having a survival rate of 99% at 1-year follow up.

The lead investigator for this study, Louis Pilote, MD, MPH, PhD, Director of the Division of General Internal Medicine at McGill University, said in a comment “Although women were more likely to be rehospitalized, they had similar outcomes to men. It has been shown that women are more concerned and aware of their health than men, so it is possible that women have a greater rate of rehospitalization because they are more inclined to consult and likely to be admitted following ER visits, given their recent ACS history.”

“The 99% survival rate at 1 year is encouraging, and is lower than mortality rates observed in prior studies of older and comparable age patients, which may indicate that practices in younger ACS adults have improved,” she added.

Reference

Pelletier R, Choi J, Winters N, et al. Sex Differences in Clinical Outcomes after Premature Acute Coronary Syndrome. Can J Cardiol. 2016 September 22. doi: 10.1016/j.cjca.2016.05.018. [Epub ahead of print]

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