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Abstract：
UNASSIGNED: There have been conflicting reports regarding outcomes in women presenting with an acute coronary syndrome (ACS).
UNASSIGNED: The objective of the study was to examine sex-specific differences in 30-day mortality in patients with ACS and acute heart failure (HF) at the time of presentation.
UNASSIGNED: This was a retrospective study of patients included in the International Survey of Acute Coronary Syndromes-ARCHIVES (ISACS-ARCHIVES; NCT04008173). Acute HF was defined as Killip classes ≥2. Participants were stratified according to ACS presentation: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTE-ACS). Differences in 30-day mortality and acute HF presentation at admission between sexes were examined using inverse propensity weighting based on the propensity score. Estimates were compared by test of interaction on the log scale.
UNASSIGNED: A total of 87,812 patients were included, of whom 30,922 (35.2%) were women. Mortality was higher in women compared with men in those presenting with STEMI (risk ratio [RR]: 1.65; 95% CI: 1.56-1.73) and NSTE-ACS (RR: 1.18; 95% CI: 1.09-1.28; P interaction <0.001). Acute HF was more common in women when compared to men with STEMI (RR: 1.24; 95% CI: 1.20-1.29) but not in those with NSTE-ACS (RR: 1.02; 95% CI: 0.97-1.08) (P interaction <0.001). The presence of acute HF increased the risk of mortality for both sexes (odds ratio: 6.60; 95% CI: 6.25-6.98).
UNASSIGNED: In patients presenting with ACS, mortality is higher in women. The presence of acute HF at hospital presentation increases the risk of mortality in both sexes. Women with STEMI are more likely to present with acute HF and this may, in part, explain sex differences in mortality. These findings may be helpful to improve sex-specific personalized risk stratification.
UNASSIGNED: The objective of the study was to examine sex-specific differences in 30-day mortality in patients with ACS and acute heart failure (HF) at the time of presentation.
UNASSIGNED: This was a retrospective study of patients included in the International Survey of Acute Coronary Syndromes-ARCHIVES (ISACS-ARCHIVES; NCT04008173). Acute HF was defined as Killip classes ≥2. Participants were stratified according to ACS presentation: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTE-ACS). Differences in 30-day mortality and acute HF presentation at admission between sexes were examined using inverse propensity weighting based on the propensity score. Estimates were compared by test of interaction on the log scale.
UNASSIGNED: A total of 87,812 patients were included, of whom 30,922 (35.2%) were women. Mortality was higher in women compared with men in those presenting with STEMI (risk ratio [RR]: 1.65; 95% CI: 1.56-1.73) and NSTE-ACS (RR: 1.18; 95% CI: 1.09-1.28; P interaction <0.001). Acute HF was more common in women when compared to men with STEMI (RR: 1.24; 95% CI: 1.20-1.29) but not in those with NSTE-ACS (RR: 1.02; 95% CI: 0.97-1.08) (P interaction <0.001). The presence of acute HF increased the risk of mortality for both sexes (odds ratio: 6.60; 95% CI: 6.25-6.98).
UNASSIGNED: In patients presenting with ACS, mortality is higher in women. The presence of acute HF at hospital presentation increases the risk of mortality in both sexes. Women with STEMI are more likely to present with acute HF and this may, in part, explain sex differences in mortality. These findings may be helpful to improve sex-specific personalized risk stratification.
摘要：
■关于出现急性冠脉综合征（ACS）的女性的结局，有相互矛盾的报道。
本研究的目的是检查ACS和急性心力衰竭（HF）患者在发病时30天死亡率的性别差异。
■这是一项纳入国际急性冠脉综合征调查（ISACS-ARCHIVES；NCT04008173）的患者的回顾性研究。急性HF定义为Killip等级≥2。根据ACS表现对参与者进行分层：ST段抬高型心肌梗死（STEMI）和非ST段抬高型ACS（NSTE-ACS）。使用基于倾向评分的反向倾向加权检查了性别之间入院时30天死亡率和急性HF表现的差异。通过对数尺度上的相互作用检验比较了估计值。
■共包括87,812名患者，其中30,922（35.2％）是女性。STEMI患者(风险比[RR]:1.65;95%CI:1.56-1.73)和NSTE-ACS患者(RR:1.18;95%CI:1.09-1.28;P交互作用<0.001)的女性死亡率高于男性。与男性STEMI患者相比，女性急性HF更为常见(RR:1.24;95%CI:1.20-1.29)，而NSTE-ACS患者则不常见(RR:1.02;95%CI:0.97-1.08)(P交互作用<0.001)。急性HF的存在增加了男女的死亡风险（比值比：6.60；95％CI：6.25-6.98）。
■在出现ACS的患者中，女性死亡率较高。在医院就诊时出现急性HF会增加男女死亡的风险。患有STEMI的女性更有可能出现急性HF，在某种程度上,解释死亡率的性别差异。这些发现可能有助于改善特定性别的个性化风险分层。
本研究的目的是检查ACS和急性心力衰竭（HF）患者在发病时30天死亡率的性别差异。
■这是一项纳入国际急性冠脉综合征调查（ISACS-ARCHIVES；NCT04008173）的患者的回顾性研究。急性HF定义为Killip等级≥2。根据ACS表现对参与者进行分层：ST段抬高型心肌梗死（STEMI）和非ST段抬高型ACS（NSTE-ACS）。使用基于倾向评分的反向倾向加权检查了性别之间入院时30天死亡率和急性HF表现的差异。通过对数尺度上的相互作用检验比较了估计值。
■共包括87,812名患者，其中30,922（35.2％）是女性。STEMI患者(风险比[RR]:1.65;95%CI:1.56-1.73)和NSTE-ACS患者(RR:1.18;95%CI:1.09-1.28;P交互作用<0.001)的女性死亡率高于男性。与男性STEMI患者相比，女性急性HF更为常见(RR:1.24;95%CI:1.20-1.29)，而NSTE-ACS患者则不常见(RR:1.02;95%CI:0.97-1.08)(P交互作用<0.001)。急性HF的存在增加了男女的死亡风险（比值比：6.60；95％CI：6.25-6.98）。
■在出现ACS的患者中，女性死亡率较高。在医院就诊时出现急性HF会增加男女死亡的风险。患有STEMI的女性更有可能出现急性HF，在某种程度上,解释死亡率的性别差异。这些发现可能有助于改善特定性别的个性化风险分层。
