Sex differences of patients with acute chest pain evaluated through a chest pain unit

Link to article at PubMed

J Cardiovasc Med (Hagerstown). 2023 Mar 21. doi: 10.2459/JCM.0000000000001466. Online ahead of print.


BACKGROUND: Although sex disparities between patients with acute myocardial infarction are well known, the data regarding sex differences among symptomatic patients with acute chest pain (ACP) are limited.

METHODS: We retrospectively evaluated the records of 1000 consecutive patients with ACP and hospitalized in a tertiary medical center chest pain unit (CPU). Patients were divided according to sex. The primary outcome was defined as a composite end point of readmission because of chest pain, incidence of acute coronary syndrome, revascularization, and death at 90 days and 1 year.

RESULTS: Overall, 673 men and 327 women were included in the current analysis. There was no difference in regard to sex for patients who underwent noninvasive evaluation, (87.8 vs. 87.3%, P = 0.85, for female vs. male, respectively). Among patients who underwent coronary computed tomography angiography, women were less likely to have significant coronary artery disease (CAD) (4.2 vs. 11.3%, P = 0.005). Similarly, women had fewer significant findings (4.4 vs. 7.6%, P = 0.007) on myocardial perfusion imaging. Consequently, fewer women underwent angiography (8 vs. 14%, P = 0.006) and revascularization (2.8 vs. 7.3%, P = 0.004). During follow-up, sex was not associated with the development of the primary composite outcome [odds ratio (OR) 0.91, 95% confidence interval (CI) 0.39-2.09, P-value = 0.82 and OR 1.16, 95% CI 0.65-2.06, P-value = 0.59 for 90-day and 1-year follow-up, respectively].

CONCLUSION: Evaluation of patients through a CPU enables comparable noninvasive evaluation, appropriate utilization of invasive assessment with similar outcomes during the short and intermediate follow-up period regardless of patients' sex.

PMID:36957985 | DOI:10.2459/JCM.0000000000001466

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