Sex Differences in Heart Failure Following Acute Coronary Syndromes
Authors' conclusion
In patients presenting with ACS, mortality is higher in women. The presence of acute HF at hospital presentation increases the risk of mortality in both sexes. Women with STEMI are more likely to present with acute HF and this may, in part, explain sex differences in mortality.
Study context
- Population
- Patients with acute coronary syndrome (ACS) (STEMI or NSTE-ACS) in the ISACS-ARCHIVES registry30,922 (35.2%) women
- Participants
- 87,812 patients
- Exposure
- Women vs men
- Womenn = 30,922
- Outcome
- Mortality, by sex and ACS presentation
- Follow-up
- 30 days
Methodological detailsinverse propensity weighting
- Inverse propensity weighting
Main finding
As reported in the abstract
30-day mortality
Women vs MenRelative risk (95% CI)
STEMI
1.65(1.56–1.73)
NSTE-ACS
1.18(1.09–1.28)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Acute HF (Killip class ≥2) at presentationWomen vs Men · STEMI | RR 1.24 (95% CI 1.20–1.29) | |
| Acute HF (Killip class ≥2) at presentationWomen vs Men · NSTE-ACS | RR 1.02 (95% CI 0.97–1.08) | |
| Mortality with vs without acute HF (both sexes) | OR 6.60 (95% CI 6.25–6.98) | |
| 0.10.31310Ratio (log scale) |
- Acute heart failure (HF) (Killip class ≥2) at presentation: P interaction <0.001
Original publication
Sex Differences in Heart Failure Following Acute Coronary Syndromes. JACC Adv. Published 26 April 2023. doi:10.
Summarised from the published abstract; every number is checked against it