Gender and age clinical characteristics of patients with acute coronary syndrome



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Cardiovascular diseases remain a common cause of morbidity and mortality in populations around the world, varying in incidence by age and gender. Every year, more than 7 million people around the world are diagnosed with acute coronary syndrome, which may be the first clinical manifestation of coronary heart disease. In the ranking of mortality causes in the Russian Federation, diseases of the circulatory system occupy a leading place. The purpose of the review was to analyze the clinical characteristics and spectrum of coronary lesions of patients with acute coronary syndrome depending on age and gender. Thus, according to the results of coronary angiography, young patients with myocardial infarction were rarely accompanied by multivessel or ostial lesions of the coronary arteries, in contrast to the elderly patients. It was revealed that multivessel lesions of the coronary arteries more often characterize males, and singlevessel lesions more often characterize females. It is obvious that the prognosis of patients with acute coronary syndrome will largely depend not only on age and gender, but also on the outcome of the syndrome, the quality and scope of diagnostic and treatment procedures. This is especially important since most patients under 60 years of age are exposed to some form of systematic work load in their field of activity. The influence of polypathy, characteristic of modern cardiac patients, can be expressed to varying degrees depending on the gender and age of the patient with acute coronary syndrome. The article presents data on the short-term and long-term prognosis of patients with acute coronary syndrome, taking into account gender and age periods, including depending on the tactics of their management. Determining the clinical characteristics of patients of different ages allows to take them into account for selecting effective and safe therapy, preventing wave-like atherosclerosis as the main cause of coronary heart disease, thereby improving prognosis and survival.

Full Text

Restricted Access

About the authors

Olga V. Boulashova

Kazan State Medical University

Email: boulashova@yandex.ru
ORCID iD: 0000-0002-7228-5848
SPIN-code: 4211-2171
Scopus Author ID: 6507198087
ResearcherId: 46110692

MD, Dr. Sci. (Med.), Prof., Department of Propaedeutics of Internal Diseases named after Prof. S.S. Zimnitsky

Russian Federation, Kazan

Elza I. Mukhitova

City clinical hospital №7 named after M.N. Sadykov

Email: elza100487@mai.ru
ORCID iD: 0000-0002-0950-0277
SPIN-code: 8957-0513

MD, Cardiologist

Russian Federation, Kazan

Elena V. Khazova

Kazan State Medical University; Kazan (Volga Region) Federal University

Author for correspondence.
Email: hazova_elena@mail.ru
ORCID iD: 0000-0001-8050-2892
SPIN-code: 7013-4320
Scopus Author ID: 57205153574
ResearcherId: O-2336-2016

MD, Cand. Sci. (Med.), Assoc. Prof., Depart of Propaedeutics of Internal Diseases Named after Professor S.S. Zimnitsky; Research, UNIL “New Professional Competences in Health Preservation”, Institute of Fundamental Medicine and Biology

Russian Federation, Kazan; Kazan

References

  1. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, Claeys MJ, Dan GA, Dweck MR, Galbraith M, Gilard M, Hinterbuchner L, Jankowska EA, Jüni P, Kimura T, Kunadian V, Leosdottir M, Lorusso R, Pedretti RFE, Rigopoulos AG, Rubini Gimenez M, Thiele H, Vranckx P, Wassmann S, Wenger NK, Ibanez B; ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J Acute Cardiovasc Care. 2024;13(1):55–161. doi: 10.1093/ehjacc/zuad107
  2. Natural movement of the population of the Russian Federation — 2019. Federal State Statistics Service. Available from: https://rosstat.gov.ru/bgd/regl/b19_106/Main.htm Accessed: Dec 28, 2023.
  3. Lunova T, Komorovsky R, Klishch I. Gender differences in treatment delays, management and mortality among patients with acute coronary syndrome: A systematic review and meta-analysis. Curr Cardiol Rev. 2023;19(1):111–126. doi: 10.2174/1573403X18666220630120259
  4. Bhatt DL, Lopes RD, Harrington RA. Diagnosis and treatment of acute coronary syndromes: A review. JAMA. 2022;327(7):662–675. doi: 10.1001/Jama.2022.0358
  5. Barbarash OL, Duplyakov DV, Zheshchikov DA, Panchenko EP, Shakhnovich RM, Yavelov IS, Yakovlev AN, Abugov SA, Alekyan BG, Arkhipov MV, Vasiliev EYu, Galyavich AS, Ganukov VI, Gilyarevsky SR, Golubev EP, Golukhova EZ, Gracianskiy NA, Karpov YuA, Kosmacheva ED, Lopatin Yu.M, Markov VA, Nikulin NN, Pevzner DV, Pogosova NV, Protopopov AV, Skrypnik DV, Tereshchenko SN, Ustyugov SA, Khripun AV, Shalaev SV, Shpektor AV, Yakushin SS. 2020 Clinical practice guidelines for acute coronary syndrome without ST segment elevation. Russian Journal of Cardiology. 2021;26(4):44–49. (In Russ.) doi: 10.15829/1560-4071-2021-4449
  6. Mozaffarian Després JP, Fullerton HJ, Howard VJ, Howard VJ, Huffman MD, Isasi CR, Jiménez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB. Heart disease and stroke statistics-2016 update: A report from the American Heart Association. Circulation. 2016;133(4):338–360. doi: 10.1161/CIR.0000000000000350
  7. Collet J, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, Dendale P, Dorobantu M, Edvardsen T, Folliguet T, Gale CP, Gilard M, Jobs A, Jüni P, Lambrinou E, Lewis BS, Mehilli J, Meliga E, Merkely B, Mueller Ch, Roffi M, Rutten FH, Sibbing D, Siontis GC. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Russian Journal of Cardiology. 2021;26(3):4418. (In Russ.) doi: 10.15829/1560-4071-2021-4418
  8. Averkov OV, Duplyakov DV, Gilyarov MY, Novikova NA, Shakhnovich RM, Yakovlev AN, Abugov SA, Alekyan BG, Arkhipov MV, Barbarash OL, Boicov SA, Vasilieva EY, Galyavich AS, Ganyukov VI, Gilyarevsky SR, Golukhova EZ, Gracianskiy NA, Zateshchikov DA, Karpov YA, Kosmacheva ED, Lopatin YM, Markov VA, Nikulin NN., Panchenko EP, Pevzner DV, Pogosova NV, Protopopov AV, Skrypnik DV, Tereshchenko SN, Ustyugov SA, Khripun AV, Shalaev SV, Shlyakhto EV, Shpektor AV, Yavelov IS, Yakushin SS. 2020 Clinical practice guidelines for Acute ST-segment elevation myocardial infarction. Russian Journal of Cardiology. 2020;25(11):257. (In Russ.) doi: 10.15829/1560-4071-2020-4103
  9. Perepech NB. Acute coronary syndrome: Pathogenesis, diagnosis, treatment, rehabilitation (part 1). Cardiosomatics. 2016;7(1):70–81. (In Russ.) doi: 10.26442/CS45215
  10. Feijo JP, Schmidt MM, David RB, Martins JMP, Schmidt KE, Gottschall CAM, Quadros A. Clinical profile and outcomes of primary percutaneous coronary intervention in young patients. Rev Bras Cardiol Invasiva. 2015;23(1):48–51. doi: 10.1016/j.rbci.2015.01.006
  11. Callachan EL, Alsheikh-Ali AA, Wallis LA. Analysis of risk factors, presentation and in-hospital events of very young patient presenting with ST-elevation myocardial infarction. J Saudi Heart Assoc. 2017;(29):270–275. doi: 10.1016/j.jsha.2017.01.004
  12. Cantarelli CMJ, Castello HJJr, Goncalves R, Oliveira GВF. Percutaneous coronary intervention in young patients. Rev Bras Cardiol Invasiva. 2014;22(4):353–358. doi: 10.1590/01041843000000059
  13. Kozlova OA, Sekitski-Pavlenko OO. Theoretical foundations for determining age boundaries and age structure of the population in the context of demographic aging. Alter Economics. 2022;19(3):446–447. (In Russ.) doi: 10.31063/AlterEconomics/2022.19-3.3
  14. Choi J, Daskalopoulou SS, Thanassoulis G, Karp I, Pelletier R, Behlouli H, Pilote L. GENESIS-PRAXY investigators. Sex- and gender-related risk factor burden in patients with premature acute coronary syndrome. Can J Cardiol. 2014;30(1):109–117. doi: 10.1016/j.cjca.2013.07.674
  15. Yunyun W, Tong L, Yingwu L, Bojiang L, Yu W, Xiaomin H, Xin L, Wenjin P, Li J. Analysis of risk factors of ST-segment elevation myocardial infarction in young patients. BMC Cardiovasc Disord. 2014;(14):179. doi: 10.1186/1471-2261-14-179
  16. Regitz-Zagrosek V, Oertelt-Prigione S, Prescott E, Franconi F, Gerdts E, Foryst-Ludwig A, Maas AH, Kautzky-Willer A, Knappe-Wegner D, Kintscher U, Ladwig KH, Schenck-Gustafsson K, Stangl V. Gender in cardiovascular diseases: Impact on clinical manifestations, management, and outcomes. Eur Heart J. 2016;37(1):24–34. doi: 10.1093/eurheartj/ehv598
  17. Lei L, Bin Z. Risk factor differences in acute myocardial infarction between young and older people: A systematic review and meta-analysis. International Journal of Cardiovascular Sciences. 2019;(32):163–176. doi: 10.5935/2359-4802.20190004
  18. Andreenko EYu, Yavelov IS, Lukyanov MM, Vernokhaeva AN, Drapkina OM, Boytsov SA. Coronary heart disease in young people: features of etiology, clinical manifestations and prognosis. Cardiologiya. 2018;58(11):24–34. (In Russ.) doi: 10.18087/cardio.2018.11.10195
  19. Zeynalov RV, Isaev EI, Samedov FM, Aliev FV, Abbasov EF. State of the coronary bed and results of endovascular treatment of young patients with acute myocardial infarction. World of medicine and biology. 2016;(1):39–44. (In Russ.) EDN: VSQNDN
  20. Ponomarenko IV, Sukmanova IA, Elykomov VA. Acute coronary syndrome in young patients: Clinical features and risk factors. Cardiovascular therapy and prevention. 2018;17(6):13–19. (In Russ.) doi: 10.15829/1728-8800-2018-6-13-19
  21. Kitulwatte ID, Pollanen MS. A comparative study of coronary atherosclerosis in young and old. Am J Forensic Med Pathol. 2015;36(4):323–336. doi: 10.1097/PAF.0000000000000203
  22. Ricci B, Cenko E, Vasiljevic Z, Stankovic G, Kedev S, Kalpak O, Vavlukis M, Zdravkovic M, Hinic S, Milicic D, Manfrini O, Badimon L, Bugiardini R. Acute coronary syndrome: The risk to young women. J Am Heart Assoc. 2017;6(12):10–11. doi: 10.1161/JAHA.117.007519
  23. Bayar N, Güven R, Erkal Z, Akyol KC, Edebali MI, Küçükseymen S, Arslan Ş. Assessment of the association between the personality traits of young patients with acute coronary syndrome and the severity of coronary artery disease. Turk Kardiyol Dern Ars. 2017;45(6):514–519. doi: 10.5543/tkda.2017.32379
  24. Lozhkina NG, Khasanova MH, Kuimov AD, Tsygankova OV, Ragino YuI, Maksimov VN, Voevoda MI. Multifactorial prognostication of remote outcomes in patients with non-ST elevation acute coronary syndrome. Kardiologiia. 2017;57(8):28–33. (In Russ.) doi: 10.18087/cardio.2017.8.10014
  25. Yang HX, Zuo HJ, Jia SJ, Li XR, Zhao X, Zhang DF, Song XT. Gender differences in risk factors and characteristics of young patients hospitalized for first acute coronary syndrome. Zhonghua Yi Xue Za Zhi. 2021;101(19):1403–1409. (In Chinese.) doi: 10.3760/cma.j.cn112137-20201013-02825
  26. Alkhawam H, Sogomonian R, El-Hunjul M, Kabach M, Syed U, Vyas N, Ahmad S, Vittorio TJ. Risk factors for coronary artery disease and acute coronary syndrome in patients ≤40 years old. Future Cardiol. 2016;12(5):545–552. doi: 10.2217/fca-2016-0011
  27. Bockeria LA, Alshibaya MM, Vishchipanov SA, Vishchipanov AS, Sokolskaya NO, Amirbekov MM, Zhalilov AK. Results of surgical treatment of coronary artery disease in young patients (under 45 years) age. Thoracic and Cardiovascular Surgery. 2014;(1):27–32. (In Russ.) EDN: SBNPON
  28. Cook NL. Bridging the sex gap in early myocardial infarction mortality: Why it matters. Circ Cardiovasc Qual Outcomes. 2017;10(12):e004334. doi: 10.1161/CIRCOUTCOMES.117.004334
  29. Manzo-Silberman S, Couturaud F, Charpentier S, Auffret V, Khoury C, Le Breton H, Belle L, Marlière S, Zeller M, Cottin Y, Danchin N, Simon T, Schiele F, Gilard M. Influence of gender on delays and early mortality in ST-segment elevation myocardial infarction: Insight from the first French Metaregistry, 2005–2012 patient-level pooled analysis. Int J Cardiol. 2018;(262):1–8. doi: 10.1016/j.ijcard.2018.02.044
  30. Bandyopadhyay D, Chakraborty S, Amgai B, Patel N, Hajra A, Heise L, Sud K, Ghosh RK, Herzog E, Aronow WS, Fonarow GC, Lavie CJ. Acute myocardial infarction in the young — National Trend Analysis with gender-based difference in outcomes. Int J Cardiol. 2020;301:218. doi: 10.1016/j.ijcard.2019.11.096
  31. Ten Haaf ME, Bax M, Ten Berg JM, Brouwer J, Van't Hof AW, Schaaf RJ, Stella PR, Tjon Joe Gin RM, Tonino PA, de Vries AG, Zijlstra F, Boersma E, Appelman Y. Sex differences in characteristics and outcome in acute coronary syndrome patients in the Netherlands. Neth Heart J. 2019;27(5):263–271. doi: 10.1007/s12471-019-1271-0
  32. Smilowitz NR, Mahajan AM, Roe MT, Hellkamp AS, Chiswell K, Gulati M, Reynolds HR. Mortality of myocardial infarction by sex, age, and obstructive coronary artery disease status in the ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry Get with the Guidelines). Circ Cardiovasc Qual Outcomes. 2017;10(12):e003443. doi: 10.1161/CIRCOUTCOMES.116.003443
  33. Cenko E, Yoon J, Kedev S, Stankovic G, Vasiljevic Z, Krljanac G, Kalpak O, Ricci B, Milicic D, Manfrini O, Schaar M, Badimon L, Bugiardini R. Sex differences in outcomes after STEMI: Effect modification by treatment strategy and age. JAMA Intern Med. 2018;178(5):632–639. doi: 10.1001/jamainternmed.2018.0514
  34. Samorodskaya IV, Bubnova MG, Akulova OA, Matveeva IF. Mortality from acute forms of coronary heart disease in men and women in the Russian Federation in 2015 and 2019. Cardiovascular Therapy and Prevention. 2022;21(6):32–73. (In Russ.) doi: 10.15829/1728-8800-2022-3273
  35. Seegers LM, Araki M, Nakajima A, Yonetsu T, Minami Y, Ako J, Soeda T, Kurihara O, Higuma T, Kimura S, Adriaenssens T, Nef HM, Lee H, McNulty I, Sugiyama T, Kakuta T, Jang IK. Sex differences in culprit plaque characteristics among different age groups in patients with acute coronary syndromes. Cardiovasc Interv. 2022;15(6):e011612. doi: 10.1161/CIRCINTERVENTIONS.121.011612
  36. Saygitov RT, Glezer MG, Sementsov DP, Malygina N.A. Gender-specific prognosis in acute coronary syndrome. Cardiovascular Therapy and Prevention. 2006;5(1):63–70. (In Russ.) EDN: ISVWUF
  37. Amsterdam EA, Wenger NK, Brindis RG, Brindis RG, Casey DE Jr, Ganiats TG, Holmes DR Jr, Jaffe AS, Jneid H, Kelly RF, Kontos MC, Levine GN, Liebson PR, Mukherjee D, Peterson ED, Sabatine MS, Smalling RW, Zieman SJ. ACC/AHA Task Force Members. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: A report of the American College of Cardiology/American Heart Association Task Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;(130): 344–426. doi: 10.1161/CIR.0000000000000133
  38. Gilyarov MYu, Zheltoukhova MO, Konstantinova EV, Muksinova MD, Muradova LSh, Nesterov AP, Udovichenko AE. Treatment characteristics of acute coronary syndrome in elderly patients: practice of N.I. Pirogov City Clinical Hospital №1. Rational Pharmacotherapy in Cardiology. 2017;13(2):164–170 (In Russ.) doi: 10.20996/1819-6446-2017-13-2-164-170
  39. Rich MW, Chyun DA, Skolnick AH, Alexander KP, Forman DE, Kitzman DW, Maurer MS, McClurken JB, Resnick BM, Shen WK, Tirschwell DL. American Heart Association Older Populations Committee of the Council on Clinical Cardiology, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Surgery and Anesthesia, and Stroke Council; American College of Cardiology; and American Geriatric Society. Knowledge gaps in cardiovascular care of the older adult population: A scientific statement from the American Heart Association, American College of Cardiology, and American Geriatrics Society. Circulation. 2016;(133):2103–2122. doi: 10.1161/CIR.0000000000000380
  40. Lopes RD, Gharacholou SM, Holmes DN, Thomas LE, Wang TY, Roe MT, Peterson ED, Alexander KP. Cumulative incidence of death and rehospitalization among the elderly in the first year after NSTEMI. Am J Med. 2015;128(6):582–590. doi: 10.1016/j.amjmed.2014.12.032
  41. De Servi S, Cavallini C, Dellavalle A, Santoro GM, Bonizzoni E, Marzocchi A, Politi A, Pesaresi A, Mariani M, Chierchia S. ROSAI-2 Investigators. Non-ST-elevation acute coronary syndrome in the elderly: Treatment strategies and 30-day outcome. Am Heart J. 2004;147(5):830–836. doi: 10.1016/j.ahj.2003.12.016
  42. Damman P, Clayton T, Wallentin L, Lagerqvist B, Fox KA, Hirsch A, Windhausen F, Swahn E, Pocock SJ, Tijssen JG, de Winter RJ. Effects of age on long-term outcomes after a routine invasive or selective invasive strategy in patients presenting with non-ST segment elevation acute coronary syndromes: A collaborative analysis of individual data from the FRISC II — ICTUS — RITA-3 (FIR) trials. Heart. 2012;98(3):207–213. doi: 10.1136/heartjnl-2011-300453
  43. Wiviott SD, Cannon CP, Morrow DA, Murphy SA, Gibson CM, Cabe CH, Sabatine MS, Rifai N, Giugliano RP, DiBattiste PM, Demopoulos LA, Antman EM, Braunwald E. Differential expression of cardiac biomarkers by gender in patients with unstable angina/non-ST-elevation myocardial infarction: a TACTICS-TIMI 8 (Treat Angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy-Thrombolysis In Myocardial Infarction 18) substudy. Circulation. 2004;109(5):580–586. doi: 10.1161/01.CIR.0000109491.66226.26
  44. Barbarash OL, Vasilyeva OA, Tavlueva EV, Zykov MV, Moiseenkov GV, Barbarash LS. Gender-related features of reperfusion therapy in patients with ST segment elevation myocardial infarction. Cardiovascular Therapy and Prevention. 2010;9(8):12–16. (In Russ.) EDN: NCXXYJ
  45. Bassand JP, Hamm CW, Ardissino D, Boersma E, Budaj A, Fernández-Avilés F, Fox KA, Hasdai D, Ohman EM, Wallentin L, Wijns W. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes of European Society of Cardiology. Eur Heart J. 2007;28(13):1598–1660. doi: 10.1093/eurheartj/ehm161
  46. Brazhnik VA, Zubova EA, Averkova AO, Minushkina LO, Khasanov NR, Kosmacheva ED, Chichkova MA, Guliev RR, Zateshchikov DA. Age-related differences in the disease course patients with acute coronary syndrome. Kremlin Medicine Journal. 2020;(3):19–26. (In Russ.) doi: 10.26269/0gs5-7066
  47. Schmidt M, Jacobsen JB, Lash TL, Bоtker HE, Sоrensen HT. 25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity: A Danish nationwide cohort study. BMJ. 2012;(344):356–364. doi: 10.1136/bmj.e356

Supplementary files

Supplementary Files
Action
1. JATS XML

© 2024 Eco-Vector





This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies