Two-Year Follow-up of Female Patients with Acute Ischemic Syndrome without ST Elevation

Objective To research clinic characteristics,therapies and 2-year progress of female patients with Non-ST-segment Elevation Acute Coronary Syndrome (NSTE-ACS).Methods This study was part of the internationalized Organization to Assess Strategies for Ischemic Syndromes (OASIS) registry.There was no intervention in the therapy.Patients admitted to hospital with NSTE-ACS (including unstable angina and non-Q wave myocardial infarction) were enrolled.The patients’ clinical characteristics,treatment procedure,major events in hospital and two-year progress were recorded by filling in Case Report Forms.Single-variate analyses were made between patients of difference genders.Results A total of 2 294 patients with NSTE-ACS were enrolled in China.The female patients were 37.7% (n=864),whose mean age was 65.1±6.7 years.Unstable angina dominant (90.7%) was noted on admission.The percentage of patients with abnormal ECG was 92.6%.The prior hypertension and diabetes were 64.1% and 23.4%,respectively,in female patients which were evidently higher than those of males (P≤0.001).The prior coronary heart disease,old myocardial infarction,smoking,and percutaneous coronary intervention (PCI) were 39.4%,16.8%,11.7%,and 2.3% respectively,in females,which were evidently lower than in males (P≤0.001).The prior history of coronary artery bypass graft (CABG) surgery was 0.5% in females,which was evidently lower than in males (P≤0.05).During hospitalization,the therapeutic rates of anti-platelets and β-adrenergic blockers were 92.8% and 64.8%,respectively,in female patients,which were observably lower than in males (P≤0.05).The therapeutic rates of nitrates,angiotensin-converting enzyme inhibitor (ACEI),calcium antagonists,lipid lowering agents were 96.9%,60.0%,59.1%,and 47.1%,respectively,in females,which were not significantly different from those of males.The medication rate in females fell off gradually after discharge,which was more evident than in males.In two-year follow up,the therapeutic rates of anti-platelets,β-adrenergic blockers,ACEI,and lipid lowering agents were 68.4%,39.5%,27.4%,and 19.4%,respectively,in female patients,which were markedly lower than those in males (P≤0.05).During hospitalization,the therapeutic rates of PCI and CABG were 10.5% and 2.7%,respectively.In two year follow-up,their therapeutic rates were 13.4% and 4.8%,respectively.The rate of females performing revascularization procedures was evidently lower than that of males (P≤0.001),either during hospitalization or in two-year follow up.In two years of follow up,mortality and incidence rates of new myocardial infarction,stroke,heart failure,hospitalization because of refractory angina were 7.4%,4.7%,6.8%,15.4%,and 31.3%,respectively,in female patients.There were no significant differences between females and males (P0.05).Conclusion Compared with male patients,female patients with NSTE-ACS are less likely to adopt and / or attach importance to treatment.As to the reason why there are no significant differences in major events of NSTE-ACS between females and males under the current circumstance that females’ treatment is inferior to males’,gender of females is an important protective factor.