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Similar outcome with an invasive strategy in men and women with non-ST-elevation acute coronary syndromes: From the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART)
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
2011 (engelsk)Inngår i: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 32, nr 24, s. 3128-3136Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Aims

To assess gender differences in outcome with an early invasive or non-invasive strategy in patients with non-ST-elevation acute coronary syndromes (NSTE ACS).

Methods and results

We included 46 455 patients [14 819 women (32%) and 31 636 men (68%)] from the SWEDEHEART register, with NSTE ACS, between 2000 and 2006, and followed them for 1 year. In the non-invasive strategy arm, the relative risk (RR) of death was (women vs. men) 1.02 [95% confidence interval (CI), 0.94-1.11] and in the invasive strategy arm 1.12 (95% CI, 0.96-1.29). After adjustment for baseline differences between the genders, with propensity score and discharge medication, there was a similar trend towards better outcome among women in both the early non-invasive cohort [RR 0.90 (95% CI, 0.82-0.99)] and the early invasive cohort [RR 0.90 (95% CI, 0.76-1.06)], although it did not reach statistical significance in the early invasive cohort. Results were similar with the combined endpoint death/myocardial infarction. An early invasive treatment was associated with a marked, and similar, mortality reduction in women [RR 0.46 (95% CI, 0.38-0.55)] and men [RR 0.45 (95% CI, 0.40-0.52)], without interaction with gender.

Conclusion

In this large cohort of patients with NSTE ACS, reflecting real-life management, women and men had similar and better outcome associated with an invasive strategy.

sted, utgiver, år, opplag, sider
2011. Vol. 32, nr 24, s. 3128-3136
HSV kategori
Identifikatorer
URN: urn:nbn:se:uu:diva-166231DOI: 10.1093/eurheartj/ehr349ISI: 000298495100017PubMedID: 21911338OAI: oai:DiVA.org:uu-166231DiVA, id: diva2:475711
Tilgjengelig fra: 2012-01-11 Laget: 2012-01-11 Sist oppdatert: 2017-12-08bibliografisk kontrollert

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