Seх differences in treatment of acute coronary syndrome patients. Data from federal registry of acute coronary syndrome 2016–2019

Introduction. Management of patients with acute coronary syndrome (ACS) is usually universal, regardless of gender, age, and ethnicity. But often in practice, gender and age influence medical decisions, and patients do not receive proper medical care. Medical care for patients with ACS was analyzed by gender according to the federal register of ACS data.

Aim. To analyze the influence of the patient's gender on the course of the disease and on the provision of medical care to patients with ACS who underwent treatment in 2016–2019.

Materials and methods. The data of 95 586 cases was analyzed. Two groups were identified: men (n=59 442, 62.2%) and women (n=36 144, 57.8%).

Results. Anamnesis analysis has revealed, that women were often more burdened with concomitant diseases and had a higher risk on the GRACE scale at admission. It was demonstrated that men underwent revascularization on average significantly more often than women (51.9% versus 32.5%, respectively, p<0.001). In women, conservative therapy was more. When compared with the appropriate use criteria for coronary revascularization, it was shown that more than 70% of women in whom a conservative treatment strategy was chosen, it was expedient to undergo myocardial revascularization using percutaneous coronary intervention.

Conclusion. Gender differences were revealed in the course of the disease, as well as in the choice of treatment by doctors. Women are characterized by a later manifestation of the disease, more often in the form of ST-ACS. The course of the disease in women is associated with a higher comorbidity, atypical symptoms and later call for help. A conservative approach prevails in the choice of ACS treatment tactics in women.