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Archivo PPCT

Las mujeres con síndromes coronarios agudos reciben menos intervenciones en la fase aguda que los hombres en una población argentina;
Women with Acute Coronary Syndromes are Less Invasively Treated than Men in the Acute Phase in an Argentine Population

Creators:Barros, Marianela; Universidad Favaloro, Bozovich, Gerardo Edgar; Fundación Favaloro y Universidad Favaloro, Buenos Aires, Argentina, Fusaro Casellas, Leandro; Universidad Favaloro, Coria, Natalia; Universidad Favaloro, Duronto, Ernesto Alfredo; Fundación Favaloro y Universidad Favaloro, Beck, Edgardo; Hospital de Agudos "Carlos G. Durand", Bozovich, Gerardo Edgar; Fundación Favaloro y Universidad Favaloro
2013-08-16

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Descripción

IntroducciónExisten antecedentes en la bibliografía científica que indican que las mujeres con enfermedadcoronaria tienen peor pronóstico que los hombres y se observa asimismo una utilización menorde métodos diagnósticos e intervenciones en ellas, por lo que resulta de interés establecer siesta tendencia existe en nuestro país y las posibles asociaciones de valor pronóstico.ObjetivosInvestigar en una cohorte argentina de síndromes coronarios agudos las características clínicas,los tratamientos y la evolución a 2 años de seguimiento.Material y métodosComponente argentino del estudio cooperativo GRACE de 4.708 hombres y 2.027 mujerescon síndromes coronarios agudos sin supradesnivel persistente del segmento ST. Se analizaronantecedentes, tipo de presentación, diagnóstico definitivo, tratamientos farmacológicos,aplicación de revascularización e incidencia acumulativa de muerte e infarto recurrente enla etapa hospitalaria y a los 6 meses y a los 2 años de seguimiento.ResultadosLas mujeres fueron mayores (69,4 ± 12,3 vs. 63,1 ± 11,9 años; p &lt; 0,01), con mayor prevalenciade insuficiencia cardíaca e hipertensión. La proporción de signos de isquemia miocárdicaen el electrocardiograma, así como la de enzimas miocárdicas en rango anormal fue similarpara ambos géneros, con un uso significativamente menor de aspirina, clopidogrel y betabloqueantesen las mujeres, quienes tuvieron la mitad de chance de angioplastia (OR: 0,55, IC95% 0,48-0,62) y de cirugía de revascularización (OR: 0,49, IC 95% 0,36-0,67), con mayoresincidencias crudas de muerte e infarto en agudo y a los 2 años, pero sin diferencia en el riesgorelativo de eventos mayores una vez ajustado por edad y otras covariables.ConclusionesA pesar de un riesgo clínico similar en mujeres y hombres, las primeras recibieron menosintervenciones durante la fase hospitalaria. Nuestros resultados llaman a un adecuado alertae intervenciones ajustadas al riesgo para el sexo femenino.

Previous studies have reported that women with acute coronary syndromes haveworse outcomes compared to men and also undergo less diagnostic tests and interventions.It would thus be useful to establish whether this trend occurs in our countryand which are the possible associations of prognostic value.ObjectiveThe aim of this study was to evaluate the clinical characteristics, treatments andoutcomes of an Argentine cohort of patients with acute coronary syndromes at2-year follow-up.MethodsThe Argentine cohort of the GRACE study included 4708 men and 2027 womenwith non-ST segment elevation acute coronary syndromes. The clinical history, typeof presentation, final diagnosis, pharmacological treatments, revascularization andcumulative incidence of mortality and reinfarction were analyzed during hospitalizationand at 6-month and 2-year follow-up.ResultsWomen were older (69.4 ±12.3 vs. 63.1 ±11.9 years; p &lt; 0.01), and had greater prevalenceof heart failure and hypertension. The proportions of ischemic electrocardiographicchanges and abnormal cardiac enzymes were similar in both sexes. Use of aspirin,clopidogrel and beta blockers was significantly lower in women, who had 50%chance of undergoing either percutaneous coronary intervention (OR= 0.55;95% CI0.48-0.62) or coronary artery bypass graft surgery (OR= 0.49; 95% CI 0.36-0.67)than men. The crude incidences of mortality and reinfarction during hospitalizationand at two-year follow up were higher in women with no differences in the relativerisk of major events after adjusting for age and other covariates.ConclusionsDespite similar risk than men to that of men, women were exposed to fewer interventionsduring hospitalization. Our results should alert physicians to indicate antiischemictreatments and interventions adjusted to risk in women.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 81, No 4 (2013); 316-321, Argentine Journal of Cardiology; Vol 81, No 4 (2013); 316-321

Citación

Barros, Marianela; Universidad Favaloro et al., “Las mujeres con síndromes coronarios agudos reciben menos intervenciones en la fase aguda que los hombres en una población argentina,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8171.

Dublin Core

Materia

Autor

Barros, Marianela; Universidad Favaloro
Bozovich, Gerardo Edgar; Fundación Favaloro y Universidad Favaloro, Buenos Aires, Argentina
Fusaro Casellas, Leandro; Universidad Favaloro
Coria, Natalia; Universidad Favaloro
Duronto, Ernesto Alfredo; Fundación Favaloro y Universidad Favaloro
Beck, Edgardo; Hospital de Agudos "Carlos G. Durand"
Bozovich, Gerardo Edgar; Fundación Favaloro y Universidad Favaloro

Fuente

Revista Argentina de Cardiología; Vol 81, No 4 (2013); 316-321
Argentine Journal of Cardiology; Vol 81, No 4 (2013); 316-321

Editor

Sociedad Argentina de Cardiología

Fecha

2013-08-16

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

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spa
eng

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion