Gender Differences In Risk Factors And Clinical Outcomes Of Acute Coronary Syndrome

Objectives:To explore whether gender is an independent risk factor for in-hospital mortality of patients over 60 years old with acute myocardial infarction,and to investigate the effect of gender and admission glucose level on in-hospital mortality in patients with acute coronary syndrome.Methods:We collected data from 3034 patients diagnosed with acute coronary syndrome during hospitalization at The Sixth Medical Center of PL A General Hospital from 2015-01-01 to 2019-12-31,including 605 old patients with acute myocardial infarction.The baseline condition and the in-hospital outcomes were compared,and multivariate Logistic regression models with the endpoint of in-hospital mortality rate were constructed to explore whether gender is an independent risk factor for in-hospital mortality in elderly patients with acute myocardial infarction.Meanwhile,we analysis the effect of gender and admission blood glucose on in-hospital mortality in patients with acute coronary syndrome by another multivariate Logistic regression model.Results:9.1%patients died during hospitalization,and the incidence of cardiac death was 8.9%.Compared with men,women have higher age of onset,more past medical history and a higher mortality rate during hospitalization.Multivariable logistic regression analyses indicated that gender is an independent risk factor for in-hospital mortality of elderly patients with acute myocardial infarction after adjusting for variation in age,Killip class,smoking status,lesion vessels,revascularization and other risk factors(women vs.men,odds ratio:3.32,95%confidence interval:1.52-7.27,P=0.003).In another study,the patients with acute coronary syndrome were divided into different groups according to sex and different levels of blood glucose.Adjusting for confounding factors,multivariable logistic regression analyses indicated that in Glu6.0-11.1,Glu>11.1 group,female has the higher in-hospital mortality than male in the same group,the mortality of female in Glu>11.1 group is higher than male groups.Conclusions:Gender is an independent risk factor for in-hospital mortality rate of elderly patients with acute myocardial infarction.In addition,admission hyperglycemia makes poor clinical outcomes for all patients with acute coronary syndrome,especially for female patients.