ACUTE CORONARY SYNDROME PATIENTS ADMITTED TO CARDIOLOGY VERSUS NON-CARDIOLOGY WARDS: VARIATIONS IN TREATMENT AND OUTCOME

Abstract

with more feminine gender scores (tertile 3) were more likely to be women, be unmarried, report high anxiety and depression, low stress management abilities, as well as more diabetes, hypertension, family history of CAD and prior CVD events before the index ACS than patients with more androgynous (tertile 2) and masculine (tertile 1) gender scores. Of the 35 (3%) patients with recurrent ACS at one year, the proportion was higher in tertile 3 (5%) than in the less feminine tertiles of the gender score: tertiles 2 (2%) and 1 (2%). This difference persisted after multivariable adjustment; patients in tertile 3 remained at greater risk of recurrent ACS than patients in tertiles 2 and 1 (HR1⁄44.50, 95% CI: 1.05-19.27, p1⁄40.04). Factors that moderated the association between feminine gender and recurrent ACS included anxiety,marital status and access to ACS care at baseline.Of note, recurrent ACS did not vary by sex: 3% in bothmales and females. CONCLUSION: In younger patients with ACS, feminine gender, but not female sex, is associated with recurrent ACS. Increased anxiety and poorer access to care in men and women with strong feminine gender characteristics may help explain this association. Studies of sex differences in cardiovascular disease should consider gender-based conceptual frameworks.