Sex-related differences in mortality and heart failure after nstacs. the cardio chus-hsuj registry

Abstract Introduction and objectives A sex-specific analysis of cardiovascular outcomes afternon-ST segment elevation acute coronary syndrome (NSTACS) using a large contemporary cohort of patients from two Spanish tertiary hospitals. Methods This retrospective observational study included 5686 consecutive NSTACS patients between the years 2003 and 2017. We performed a propensity score matching to obtain a well-balanced subset of patients, resulting in 3120 patients. Cox regression models performed survival analyses once proportional risk test were verified. Results Among the study participants, 1572 patients (27.6%) were women. The median follow-up was 60.0 months (standard deviation 32 months). Women had higher risk of cardiovascular mortality compared with men (OR (Odds ratio) 1.27, CI (confidence interval) 95% 1.08–1.49) and heart failure (HF) hospitalization (OR 1.39, CI 95% 1.18–1.63), but a similar risk of all-cause mortality (OR 1.10, CI 95% 1.08–1.49). After a propensity score matching, women were associated with a significant reduction in the risk of total mortality (OR 0.77, CI 95% 0.65–0.90) with a similar risk of cardiovascular mortality (OR 0.86, CI 0.71–1.03) and HF hospitalization (OR 0.92, CI 95% 0.68–1.23). After adjustment for baseline characteristics, the risks of all-cause mortality and cardiovascular mortality were less in women; although the risk of HF was similar among sexes. Conclusions Women are at similar risk to develop early and late HF admissions after NSTACS, and have better survival compared with male, with lower risk of all-cause mortality and cardiovascular mortality. Multivariable analysis Total mortality Cardiovascular mortality HF hospitalization HR (CI 95%) p-value HR (95% CI) p-value HR (95% CI) p-value Female 0,68 (0,58–0,79)