SEX DIFFERENCES IN DISTRIBUTION, MANAGEMENT AND OUTCOMES OF COMBINED ISCHEMIC-BLEEDING RISK FOLLOWING ACUTE CORONARY SYNDROME

Rashid; Mamas

Abstract

Background: Risk factors of bleeding and recurrent ischemic events after acute coronary syndrome (ACS) often overlap. Whether the distribution and management of these complications vary by sex remains unknown. Methods: ACS hospitalizations in the United Kingdom between 2010 and 2017 were retrospectively analyzed, stratified by sex and bleeding-ischaemic risk combination (using CRUSADE and GRACE scores). Regression analyses were performed to examine the association between risk-groups and receipt of percutaneous coronary intervention (PCI) and dual antiplatelet therapy (DAPT) on discharge, as well as in-hospital clinical outcomes. Results: Out of 584,360 patients, a third of males (32.3%) and females (32.6%) were in the dual high bleeding-ischemic risk group. Dual high-risk patients of both sexes were less likely to receive PCI and DAPT, with a significant increase in odds of MACE, allcause and cardiac mortality, and bleeding (see figure), with the greatest difference between sexes observed in the dual-high risk group in which females were less likely to receive guideline-recommended therapy (PCI and DAPT) and more likely to experience adverse outcomes. Conclusion: ACS patients with dual high bleeding-ischemic risk are less likely to receive guideline-recommended therapy and experience significantly worse outcomes, especially in females. Novel strategies are needed to effectively manage this highly prevalent and complex patient group and address the under-treatment of females.

Citation

Rashid, & Mamas. (2021). SEX DIFFERENCES IN DISTRIBUTION, MANAGEMENT AND OUTCOMES OF COMBINED ISCHEMIC-BLEEDING RISK FOLLOWING ACUTE CORONARY SYNDROME. Journal of the American College of Cardiology, 39 - 39. https://doi.org/10.1016/S0735-1097%2821%2901398-X

• Acceptance Date: May 3, 2021
• Publication Date: May 11, 2021
• Journal: Journal of the American College of Cardiology
• Print ISSN: 0735-1097
• Publisher: Elsevier
• Pages: 39 - 39
• Series Title: ACC.21 Virtual
• DOI: https://doi.org/10.1016/S0735-1097%2821%2901398-X
• Public URL: https://keele-repository.worktribe.com/output/420410
• Publisher URL: https://www.jacc.org/doi/10.1016/S0735-1097%2821%2901398-X