Introduction: Numerous studies were focused on coronary artery disease, most of them in the male population and it seems that data on gender differences in CAD were extrapolated from these studies.
Goal: The multi-center prospective study was designed to analyze gender differences in features, clinical presentation, and early in-hospital mortality in patients with acute coronary syndrome (ACS) admitted to coronary units in 50 hospitals in Serbia, during a 12 month-period.
Methods: The data were collected from the central register of ACS, analyzed with respect to gender differences. The study protocol included all consecutive patients with diagnosis of ACS. In the study 12,094 patients were analyzed, 7639 men and 4455 women. Women were significantly older than men in all ACS manifestations (p < 0.001).
Results: Incidence of myocardial infarction (MI) in women was the highest between the 7th and 8th life decade, while in men the highest incidence is observed between their sixties and seventies. Equalization in the incidences of MI in men and women is observed between the sixth and seventh life decades. There were significant differences in the incidence of fibrinolytic therapy and heart failure (p < 0.001) in favor of women. Women with unstable angina and NSTEMI had higher in-hospital mortality (2.4% vs. 1.7% and 9.0% vs. 7.1%, respectively), without statistical significance, while in STEMI the difference was highly statistically significant (16.1% compared to men 10.1), p < 0.001.
Discussion: The mean age of the greatest frequency of occurrence of MI has been shifted five years earlier in the population of women, different from other studies related to the analysis of MI by gender differences.
Conclusion: Female mortalitywas significantly higher compared to the male population, thus more aggressive therapy should be administrated.