Effects of gender on the number of diseased vessels and clinical outcome in Japanese patients with acute coronary syndrome

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• It has been reported that women with acute myocardial infarction (AMI) have a higher short-term mortality rate than men, but the reason is unclear and it is not known if it also applies to unstable angina pectoris (UAP). In addition, most previous studies have not presented angiographic findings. In the present study, the findings from 1,408 patients with AMI (group A: 361 women, 1,047 men) and 332 patients with UAP (group B: 103 women, 229 men) who underwent coronary angiography within 30 days of onset were analyzed. In both groups, the women were older and had a higher rate of hypertension and a lower rate of smoking than the men. There was no significant difference in Killip class or the number of diseased vessels between the women and men in both groups. Interventions (coronary angioplasty and coronary artery bypass grafting) were performed less frequently in the women than in the men (87.2% vs 91.8%, p=0.04) in group A, but not in group B (80.6% vs 81.2%, NS). In both groups, the overall mortality rate during hospitalization was higher in women than in men (group A: 14.4% vs 7.4%, p<0.0001, group B: 7.8% vs 1.7%, p=0.007). Multivariate analysis revealed that female gender was an independent predictor of in-hospital mortality in group B (odds ratio (OR): 6.4, 95% confidence interval (CI) 1.1-37.0, p=0.04), but not in group A (OR: 1.7, 95% CI 0.98-2.9, p=0.06). The independent predictors of in-hospital mortality, other than female gender were age, prior congestive heart failure, prior cerebrovascular disease and a higher Killip class in group A, and in both groups a higher number of diseased vessels. In conclusion, Japanese women with acute coronary syndromes present with similar angiographic findings and hemodynamics, but have a higher in-hospital mortality than male patients. Our results suggest that older age may be a potential explanation for the higher in-hospital mortality in women with AMI, but female gender itself may be an important predictor for it among those with UAP.

• 社団法人日本循環器学会の論文
• 2002-04-20

著者

• Terai Hidenobu

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Ino Hidekazu

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Hayashi Kenshi

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Hayashi Tatsumi

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Shimizu Masami

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Yamaguchi Masato

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Sakata Kenji

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Inoue Masaru

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Mabuchi Hiroshi

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Inoue Masaru

  Division Of Cardiology Ishikawa Prefectural Hospital

• Sakata Kenji

  金沢大学 医学系研究科循環器内科学

• Kaneda Tomoya

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Kaneda Tomoya

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Oe Kotaro

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Kiyama Masaru

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Ohosato Kazuo

  Fukui Cardiovascular Center

• Shimizu Masami

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Terai Hidenobu

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Hayashi Tatsumi

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Kanazawa Universi

• Oe Kotaro

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Ohe Koutarou

  Fukui Cardiovascular Center

• Sakata Kenji

  Department Of Cardiology Ishikawa Prefectural Central Hospital

• Kametani Tomio

  Department Of Internal Medicine Koseiren Takaoka Hospital

• Haraki Tatsuo

  Department Of Internal Medicine Komatsu Municipal Hospital

• Itoh Hideki

  Department Of Emergency And Critical Care Medicine Kanazawa University Hospital

• Mabuchi Hiroshi

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Yamaguchi Masato

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

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