Search

Abstract Background The current study was to compare the management and clinical outcome between women and men with acute coronary syndrome (ACS). Method This was a retrospective study. Patients with ACS presented to the emergency department were enrolled. Management and clinical outcomes (including mortality and acute decompensated heart failure [ADHF]) were compared between women and men. Results A total of 686 patients were included and women accounted for 38.5% (n = 264). Women were less likely to receive ticagrelor at the emergency department (18.2% vs 25.1%). Duration from arrival at the emergency department to undergo electrocardiogram was longer in women (7.5 min vs 5.3 min). The duration from symptom onset to undergo percutaneous coronary intervention was longer in women (14.4 h vs 7.2 h). After adjusting for covariates, odds ratio (OR) for cardiovascular mortality was 0.42 (95% confidence interval [CI] 0.37–1.02) and ADHF was 0.63 (95% CI 0.55–1.01) for women vs men. Socioeconomic status, duration from symptom onset to arrive at the emergency department, and management at the emergency department were the important factors contributing to the sex-differences in clinical outcome. Conclusion Among ACS patients undergoing PCI, there was no sex-difference in in-hospital clinical outcome after adjusting for covariates. Future studies are needed to evaluate whether improving management at the emergency department can improve clinical outcomes in women and men with ACS.

Introduction Dyslipidemia combined with hypertension increases the risk of cardiovascular disease (CVD). The current study aimed to investigate the association of dipping and non-dipping hypertension with CVD in patients with dyslipidemia. Material and methods A total of 243 documented dyslipidemia patients with hypertension were enrolled. Clinical characteristics and clinic and 24-hour blood pressure (BP) parameters were compared between dipping and non-dipping groups based on 24-hour ambulatory blood pressure monitoring. Logistic regression analysis was performed to evaluate the association of dipping and non-dipping hypertension with CVD. Results Compared to the dipping group, patients in the non-dipping group were older, more likely to be male and smokers, had higher serum creatinine levels, and were more likely to have chronic kidney disease and CVD (p < 0.05 for all comparisons). No significant between-group differences in clinic systolic and diastolic BP (SBP and DBP) were observed. However, compared to the dipping group, 24-hour SBP, nighttime SBP and DBP, and night-day ratio of SBP and DBP were all significantly higher in the non-dipping group (p < 0.05 for all comparisons). In the dipping group, only night-day ratio of SBP was significantly associated with CVD, with an odds ratio (OR) of 1.09 (95% confidence interval (CI) of 1.02–1.34). In the non-dipping group, both night-day ratio of SBP and DBP were significantly associated with CVD, with an OR of 1.72 (95% CI: 1.33–2.06) and 1.23 (95% CI: 1.05–1.66), respectively. Conclusions In patients with dyslipidemia, non-dipping hypertension is more closely related to CVD compared to dipping hypertension.