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Year : 2017  |  Volume : 18  |  Issue : 3  |  Page : 77-82

Gender differences among patients with acute coronary syndrome in the Middle East

1 Department of Medicine, Al-Amiri Hospital, Kuwait
2 Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University and Oman Gulf Health Research, Muscat, Oman
3 Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait
4 Department of Medicine, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait

Correspondence Address:
Aliah Ali Khesroh
Senior Registrar, Internal Medicine, Al-Amiri Hospital, PO Box 26866, Safat 13001
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Source of Support: None, Conflict of Interest: None


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Background: There is controversy regarding the relationship between gender and acute coronary syndrome (ACS). Objective: To study the impact of gender on presentation, management, and mortality among patients with ACS in the Middle East. Methodology: From January 2012 to January 2013, 4057 patients with ACS were enrolled from four Arabian Gulf countries (Kuwait, Oman, United Arab Emirates, and Qatar), representing more than 85% of the general hospitals in each of the participating countries. Results: Compared to men, women were older and had more comorbidities. They also had atypical presentation of ACS such as atypical chest pain and heart failure. The prevalence of non-ST-segment elevation myocardial infarction (49 vs. 46%; P < 0.001) and unstable angina (34 vs. 24%; P < 0.001) was higher among women as compared to men. In addition, women were less likely to receive evidence-based medications such as aspirin, clopidogrel, beta-blocker, and angiotensin-converting enzyme inhibitors on admission and on discharge. During hospital stay, women suffered more heart failure (15 vs. 12%; P = 0.008) and were more likely to receive blood transfusion (6 vs. 3%; P < 0.001). Women had higher 1-year mortality (14 vs. 11%; P < 0.001), the apparent difference that disappeared after adjusting for age and other comorbidities. Conclusion: Although there were differences between men and women in presentation, management, and in-hospital outcomes, gender was shown to be a nonsignificant contributor to mortality after adjusting for confounders.

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