Observation of serious adverse cardiovascular events over 3 years in patients with advanced atherosclerosis: is there a gender difference?
Dyslipidemia has been widely acknowledged as one of the major predisposing factors for the development and progression of atherosclerosis. While advanced atherosclerosis confirmed to influence the prognosis of patients with acute coronary syndrome (ACS), it has not yet been established, whether this impact is gender-dependent.


AIM
The aim of study was to investigate possible gender-related effect of dyslipidemia and generalized atherosclerosis on the long-term outcomes in patients with ACS.


MATERIALS AND METHODS
A total of 247 patients (88 women and 159 men) with ACS were included. Sample was divided into two groups, according to gender. Patients' lipid and comorbidity profiles were assessed. Cumulative major adverse coronary events (MACE) were estimated throughout 3-year follow-up period.


RESULTS
Women were older and had more comorbidities. Cumulative 3-year MACE rates were higher in women than in men (33% vs. 23%, p=0.06). In the multivariable Cox regression analysis abnormal lipid profiles were more significantly associated with higher MACE in females (HR=1.5, 95% CI [1-2,28], p<0.00001), compared with males (HR=1.0, 95% CI [0.5-2.08], p=0.4), as well as prior MI: (HR=3.8, 95% CI [1.4- 10.5], p<0.00001) vs. (HR=1.9, 95% [0.8-4.2], p=0.009) and concomitant peripheral artery disease (PAD): (HR=5.2, 95% CI [1.5-18.2], p<0.00001) vs. (HR=2.2, 95% CI [0.73-6.6], p=0.02) respectively.


CONCLUSIONS
In our study dyslipidemia, concomitant PAD and history of MI were independent predictors of higher MACE more significantly in females with ACS than in males. Thus, it can be assumed that female patients require an increased medical attention with strict serum lipid control.
['Lunova|Tetiana|T|', 'Levytska|Larysa|L|', 'Kucher|Svitlana|S|', 'Shatskyi|Viktor|V|', 'Habor|Halyna|H|', 'Klishch|Ivan|I|']
D054058:Acute Coronary Syndrome D050197:Atherosclerosis D005260:Female D006801:Humans D008297:Male D011379:Prognosis D016016:Proportional Hazards Models D012307:Risk Factors D012727:Sex Characteristics D012737:Sex Factors
atherosclerosis gender differences outcomes