Treatment and short-term outcome in women and men with acute coronary syndromes

Int J Cardiol. 2005 Aug 18;103(2):120-7. doi: 10.1016/j.ijcard.2004.07.015.


Objective: To study differences in treatment and early morbidity and mortality in relation to gender, type of acute coronary syndrome (ACS) and age in patients under 80 years of age.

Methods: We studied 1744 consecutive patients with ACS with assumed decreasing order of severity [ST-elevation myocardial infarction (MI), non-ST-elevation MI and unstable angina of high- and low-risk types] admitted to the coronary care unit at Sahlgrenska University Hospital.

Results: The use of thrombolysis and percutaneous coronary interventions (PCI) did not differ significantly between gender groups and women did not suffer from more severe complications than men. Treatment with beta-blockers, ACE inhibitors and aspirin was used on a similar scale among women and men. In-hospital complications and use of intravenous drugs were strongly associated with severity of disease in a similar way among women and men. The mortality rates at 30 days were 12.4% and 7.4% in MI with and without ST-segment elevation, but only 1.3% and 1.0% in unstable angina of high- and low-risk types. The use of primary PCI decreased with age, as did coronary angiography and PCI in the subacute phase, irrespective of gender.

Conclusion: Among patients <80 years with ACS admitted to a coronary care unit, the suspicion that women are treated less aggressively than men could not be verified. Nor did women suffer from more complications or have a significantly higher 30-day mortality than men. Elderly patients were significantly less likely to undergo invasive procedures than those of a younger age, irrespective of gender.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Adrenergic beta-Antagonists / therapeutic use
  • Age Factors
  • Aged
  • Angina, Unstable / diagnostic imaging
  • Angina, Unstable / therapy
  • Angioplasty, Balloon, Coronary*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Coronary Angiography
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / therapy*
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / therapy
  • Myocardial Reperfusion
  • Severity of Illness Index
  • Sex Factors
  • Survival Rate
  • Syndrome
  • Time Factors
  • Treatment Outcome


  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Fibrinolytic Agents