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. 2022 Sep 6:42:101118.
doi: 10.1016/j.ijcha.2022.101118. eCollection 2022 Oct.

Sex differences in long-term outcomes in older adults undergoing invasive treatment for non-ST elevation acute coronary syndrome: An ICON-1 sub-study

Hanna Ratcovich  1   2 , Mohammad Alkhalil  1   3 , Benjamin Beska  1   3 , Lene Holmvang  2 , Mike Lawless  1   3 , I Gede Dennis Sukadana  1   4 , Chris Wilkinson  3   5 , Vijay Kunadian  1   3
Affiliations

Sex differences in long-term outcomes in older adults undergoing invasive treatment for non-ST elevation acute coronary syndrome: An ICON-1 sub-study

Hanna Ratcovich et al. Int J Cardiol Heart Vasc. .

Abstract

Background: Cardiovascular disease is the leading cause of mortality for females globally, yet females are underrepresented in studies of acute coronary syndrome (ACS). Studies investigating sex-related differences in clinical outcomes of patients with non-ST elevation ACS (NSTEACS) have reported divergent results, and it is unknown whether long-term outcomes for older people with NSTEACS differ between males and females.

Methods: The multi-centre prospective cohort study, ICON-1, consisted of patients aged ≥75 years undergoing coronary angiography following NSTEACS. The primary composite endpoint was all-cause mortality, myocardial infarction, unplanned revascularisation, stroke, and bleeding. We report outcomes at five-years by sex.

Results: Of 264 patients, 102 (38.6%) females and 162 (61.4%) males completed the five-year follow-up and were included in the analytic cohort. At admission, females were older than males (82 ± 4.3 years vs 80.0 ± 4.1 years p = 0.018). Co-morbidity profile and GRACE score were similar between the groups. There were no differences in the provision of invasive or pharmacological treatments between sexes. At five-years, there were no association between sex and the primary outcome.

Conclusion: In older adults with invasive treatment of NSTEACS, provision of guideline-indicated care and long-term clinical outcomes were similar between males and females.

Keywords: Ageing; Females; Non-ST elevation acute coronary syndrome; Sex-differences.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Cumulative incidence of five-year primary endpoint stratified by sex.
Fig. 2
Fig. 2
Factors associated with five-years primary endpoint CI = confidence interval, HR = hazard ratio, MI = myocardial infarction.
See this image and copyright information in PMC

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