Gender Differences In Clinical Presentation Research Articles

Adult congenital heart disease in women: demographics and outcomes in mexico. gender differences?

Abstract Background Due to advances in cardiovascular medicine in recent decades, adult congenital heart disease (ACHD) is becoming a growing field in cardiology. Differences in clinical presentation, treatment, and outcomes of ACHD between men and women have not been well studied in Latin America and Mexico. Purpose To characterize gender differences in clinical presentation, treatment, and mortality of ACHD in Mexico. Methods From January 2006 to December 2020, 3503 patients with ACHD were studied at a cardiology national reference center in Mexico. SPSS V. 23 software was used for statistical analysis. Results Women comprised 56% of the study population, in which a higher percentage of pulmonary hypertension and Eisenmenger syndrome was observed, (10.9% men vs. 17.7% women; 1.5% men vs. 3.3% women, p <0.01). Women had a higher score in AHA´s physiological classification (State C, 27.9% men vs. 35.3% women, p <0.01). Men had a higher rate of severity/anatomic complexity (13.3% men vs. 11.7% women, p <0.01), a higher rate of LVEF <40%, (8.0% men vs. 23.8% women, p <0.01), and underwent total repair surgery more often (61.3% men vs. 57% women, p <0.01). No statistical difference was observed in functional class, presence of arrhythmias, or mortality (patient´s current status). Figure 1. Conclusions We found gender differences in ACHD in Mexico: women were more likely to have pulmonary hypertension, which may reflect the already known gender predilection of PH; additionally, women had a higher AHA's physiological score; despite this, women underwent complete surgery less frequently. Although men had higher anatomic complexity and a lower LVEF, there was no statistical difference in functional class or mortality.Figure 1

Gender-related differences in patients with carcinoid syndrome: new insights from an Italian multicenter cohort study

BackgroundThe incidence of neuroendocrine neoplasm (NEN) and related carcinoid syndrome (CaS) has increased markedly in recent decades, and women appear to be more at risk than men. As per other tumors, gender may be relevant in influencing the clinical and prognostic characteristics of NEN-associated CS. However, specific data on carcinoid syndrome (CaS) are still lacking.PurposeTo evaluate gender differences in clinical presentation and outcome of CaS.MethodsRetrospective analysis of 144 CaS patients from 20 Italian high-volume centers was conducted. Clinical presentation, tumor characteristics, therapies, and outcomes (progression-free survival, PFS, overall survival, OS) were correlated to gender.ResultsNinety (62.5%) CaS patients were male. There was no gender difference in the site of primary tumor, tumor grade and clinical stage, as well as in treatments. Men were more frequently smokers (37.2%) and alcohol drinkers (17.8%) than women (9.5%, p = 0.002, and 3.7%, p = 0.004, respectively). Concerning clinical presentation, women showed higher median number of symptoms (p = 0.0007), more frequent abdominal pain, tachycardia, and psychiatric disorders than men (53.3% vs 70.4%, p = 0.044; 6.7% vs 31.5%, p = 0.001; 50.9% vs. 26.7%, p = 0.003, respectively). Lymph node metastases at diagnosis were more frequent in men than in women (80% vs 64.8%; p = 0.04), but no differences in terms of PFS (p = 0.51) and OS (p = 0.64) were found between gender.ConclusionsIn this Italian cohort, CaS was slightly more frequent in males than females. Gender-related differences emerged in the clinical presentation of CaS, as well as gender-specific risk factors for CaS development. A gender-driven clinical management of these patients should be advisable.

Demographic characteristics, clinical presentation and in-hospital outcome among patients with Covid-19 in a Nigerian tertiary hospital.

We described the demographic/clinical characteristics and in-hospital outcome of patients with COVID-19 at the University of Nigeria Teaching Hospital (UNTH) during the first wave to inform evidence-based responses during subsequent waves in Africa. We conducted retrospective cohort analyses of adult patients ≥18 years with PCR or GeneXpert-confirmed SARS-CoV-2 infection. Data was extracted from patients' medical records from 1st May to 30th September 2020. Based on disease severity, patients were either hospitalized (82) or managed at home (90). Logistic regression and cox-proportional hazard models were used to determine predictors of severe COVID-19 disease and in-hospital mortality, respectively. Of 172 cases, 113 (65.7%) were males, and the mean age was 45 ± 19 years. The majority were urban dwellers (72.1%), 19.8% had a positive history of contact with a confirmed/suspected case, 15.7% were healthcare workers while 68 (39.5%) had co-morbidities. Symptomatic patients comprised 73.3% of cases. Fever (p=0.02) and breathlessness (p=0.03) were commoner in males while diarrhoea (p<0.01) was predominant in females. On multivariate analysis, severe COVID-19 was predicted by the presence of co-morbidity (AOR= 14.44, 95% C.I= 4.79- 43.58, p <0.001)and prior antibiotic/antimalarial use (AOR= 6.35, 95% C.I= 2.24- 18.05, p =0.001) while being a non-healthcare worker (AOR= 0.18, 95% C.I= 0.04-0.78, p=0.02) was protective. However, none of the variables assessed predicted in-hospital mortality. Our findings underscore the contributions of demographic variables in COVID-19 transmission and gender differences in clinical presentation. Underlying comorbidity likewise prior antimicrobial use increased the likelihood of severe COVID-19. The absence of mortality predictors in our study may be related to the relatively small number of deaths. Further studies are recommended to unravel the predominance of severe disease in healthcare workers.

Further analysis of natural antibodies against ischemic stroke.

Our previous study revealed that circulating levels of IgG natural antibodies (NAbs) for vascular endothelial growth factor receptor 1 (VEGFR1) were significantly decreased in patients with arteriosclerosis compared with control subjects. To enhance the sensitivity of an enzyme-linked immunosorbent assay (ELISA) developed in-house for antibody testing, the present work was designed to investigate additive signals in the in-house ELISA developed with the combination of two or more linear peptide antigens derived from target proteins of interest, including VEGFR1, oxidized low-density lipoprotein receptor 1 (LOX-1), interleukins 6 (IL6) and 8 (IL8). A total of 218 patients with ischemic stroke and 198 healthy controls were enrolled and an in-house ELISA was developed with linear peptides derived from VEGFR1, LOX-1, IL6, and IL8 to detect their IgG levels in plasma. Compared with control subjects, plasma levels of IgG NAbs for the IL6-IL8 combination were significantly lower in female patients (Z = -3.149, P = 0.002), whereas male patients showed significantly lower levels of plasma anti-VEGFR IgG (Z = -3.895, P < 0.001) and anti-LOX1a IgG (Z = -4.329, P < 0.001). Because plasma levels of IgG NAbs for both the IL6-IL8-LOX1a-LOX1b combination and the VEGFR1a-VEGFR1b-LOX1a-LOX1b combination were significantly lower in the patient group than the control group, receiver operating characteristic (ROC) analysis was performed and the results showed that the VEGFR1a-VEGFR1b-LOX1a-LOX1b combination had an area under the ROC curve (AUC) of 0.70 for its IgG assay with a sensitivity of 27.1% against the specificity of 95.5% and that the IL6-IL8-LOX1a-LOX1b combination had an AUC of 0.67 for its IgG assay with a sensitivity of 21.1% against the specificity of 95.5%. Spearman correlation analysis showed that plasma IgG NAbs against the IL6-IL8 combination were positively correlated with carotid plaque size only in male patients (r = 0.270, p = 0.002). Circulating IgG NAbs for the target molecules studied may be potential biomarkers for a subgroup of ischemic stroke and also contribute to the gender differences in clinical presentation of the disease.

AN UPDATE ON ASSESSMENT AND MANAGEMENT OF ASD AND ASSOCIATED PSYCHOPATHOLOGY

This Institute provides an evidence-based clinically relevant review of the screening, diagnosis, and management of ASD and frequently associated psychopathologies in psychiatrically referred children and adolescents. Clinicians will also learn about the age and gender differences in clinical presentation, sleep-related issues, social skills interventions, and a critical review of the evidence for various novel interventions. This full-day program was developed specifically for mental health providers serving psychiatrically referred populations of youth with ASD.

Gender Differences in Cardiogenic Shock Patients: Clinical Features, Risk Prediction, and Outcomes in a Hub Center.

IntroductionThere is scarce knowledge about gender differences in clinical presentation, management, use of risk stratification tools and prognosis in cardiogenic shock (CS) patients.PurposeThe primary endpoint was to investigate the differences in characteristics, management, and in-hospital mortality according to gender in a cohort of CS patients admitted to a tertiary hub center. The secondary endpoint was to evaluate the prognostic performance of the Society of Cardiovascular Angiography and Interventions (SCAI) classification in predicting in-hospital mortality according to sex.MethodsThis is a retrospective single-Center cohort study of CS patients treated by a multidisciplinary shock team between September 2014 and December 2020. Baseline characteristics and clinical outcomes according to gender were registered. Discrimination of SCAI classification was assessed using the area under the receiver operating characteristic curve (AUC).ResultsOverall, 163 patients were included, 39 of them female (24%). Mean age of the overall cohort was 55 years (44–62), similar between groups. Compared with men, women were less likely to be smokers and the prevalence of COPD and diabetes mellitus was significantly lower in this group (p < 0.05). Postcardiotomy (44 vs. 31%) and fulminant myocarditis (13 vs. 2%) were more frequent etiologies in females than in males (p = 0.01), whereas acute myocardial infarction was less common among females (13 vs. 33%). Regarding management, the use of temporary mechanical circulatory support, mechanical ventilation, or renal replacement therapy was frequent and no different between the groups (88, 87, and 49%, respectively, in females vs. 42, 91, and 41% in males, p > 0.05). In-hospital survival in the overall cohort was 53%, without differences between groups (52% in females vs. 55% in males, p = 0.76). Most of the patients (60.7%) were in SCAIE at presentation without differences between sexes. The SCAI classification showed a moderate ability for predicting in-hospital mortality (overall, AUC: 0.653, 95% CI 0.582–0.725). The AUC was 0.636 for women (95% CI 0.491–0.780) and 0.658 for men (95% CI 0.575–0.740).ConclusionsOnly one in four of patients treated at a dedicated CS team were female. This may reflect differences in prevalence of severe heart disease at young (<65) ages, although a patient-selection bias cannot be ruled out. In this very high-risk CS population of multiple etiologies, overall, in-hospital survival was slightly above 50% and showed no differences between sexes. Treatment approaches, procedures, and SCAI risk stratification performance did not show gender disparities among treated patients.

TCTAP A-013 Gender Differences in Clinical Presentation, Primary Angioplasty Results, In-Hospital Mortality and Long-Term Outcomes of ST-Elevation-MI in a Tertiary Care Center in India

TCTAP A-013 Gender Differences in Clinical Presentation, Primary Angioplasty Results, In-Hospital Mortality and Long-Term Outcomes of ST-Elevation-MI in a Tertiary Care Center in India

Gender Differences in Patients With Stable Chest Pain

This study sought to investigate gender differences in clinical presentation, presence, and extent of coronary artery disease (CAD), and all-cause mortality in patients with stable chest pain who underwent coronary computed tomography angiography (CCTA). Patients who visited the fast-track outpatient clinic of the Erasmus Medical Center and underwent CCTA were analyzed. Clinical characteristics of chest pain, CAD on CCTA, coronary artery calcium scores, and survival were collected retrospectively and compared between men and women. Logistic regression was used to identify independent risk factors for the presence of CAD and Cox regression for all-cause mortality. In 1,835 included patients, 966 (52.6%) were female. Men and women were similar in age (55 vs 56years). Compared with men, women had a lower frequency of typical pain (22.8% vs 31.1%, p<0.001), lower prevalence of significant CAD (22.2% vs 38.1%, p<0.001), and lower coronary artery calcium scores (p <0.001). CAD was more prevalent in men than in women with typical pain (67.4% vs 35.9%, p<0.001) and also with nontypical pain (24.9% vs 18.1%, p=0.002). After adjustment for baseline characteristic, male sex was associated with all-cause mortality (adjusted hazard ratio 1.87, 95% confidence interval 1.25 to 2.80, p=0.002). The additional risk of mortality because of CAD was similar between men and women. Stratifying by typical and nontypical pain, women again had a better prognosis. Our study identifies gender-related differences in characteristics, CCTA-findings, and outcomes for women compared with men presenting for CCTA with chest pain. Women have less CAD and a better prognosis than men, the clinical implications of which require further study.

P169 Delayed diagnosis of inflammatory bowel disease in women: Characterization and use of health resources

Abstract Background Delayed diagnosis of IBD is associated with increased complications. Female gender is one of the factors most frequently associated with delayed diagnosis. Higher prevalence of functional gastrointestinal disorders in women probably hinders the diagnosis of IBD. The aim of this study is to explore delayed diagnosis of IBD and assess differences between women and men in healthcare access routes. Methods This multicentre prospective cohort study included 190 patients with newly diagnosed IBD. Data were collected on clinical and demographic characteristics, IBD activity and systematic reconstruction of the diagnostic process in a semi-structured interview together with a review of their medical record. Results Figure 1 shows clinical and demographic characteristics. In CD, patients’ symptoms were similar between both genders, except for a higher incidence of bowel incontinence, arthralgias, asthenia and other symptoms in women. In UC, there was no gender difference in clinical presentation. Overall, the median time from symptom onset to IBD diagnosis was 4.5(2.1–12.9) months, being significantly longer in women than in men, 7.8(3.3–18.9) vs. 3.8(1.7–7.8) p&amp;lt;0.001. In diagnostic process, the time from symptom onset to initial physician visit was 0.7(0.26–2) months with no statistically significant differences between women and men. While the time from initial physician visit to IBD diagnosis was 3.4(1.1–7.4) months with a longer time in women than in men 4.2(1.9–11.1) vs 2.2(0.82–5.1) p&amp;lt; 0.001. Figure 2 shows the different diagnostic times by sex in CD and UC. Misdiagnosis were reported in 61.6%, women had a higher percentage of misdiagnosis than men, 77.3% vs 48% (OR 3.6; 95% CI 1.9–6.9). These differences between women and men were maintained in CD 83% vs 55.3 (OR 3.9; 95% CI 1.5–9.9) and in UC 68.6% vs 41.8% (OR 3; 95% CI 1.2–7.4). Misdiagnosis were observed in 66/120 (55%) patients evaluated in Emergency Department, 89/166 (53.6%) in Primary Health Care, 25/122 (20.5%) in Gastroenterology Outpatient Clinics, 4/11(36.5) in another medical specialist, and 14/84 (16.7) in Hospital Admission. Women had a higher percentage of misdiagnosis, in Emergency Department 66.1%/44.3% (OR 2.4; 95% CI 1.1–5.1), Primary Health Care 65.1%/42.2% (OR 2.5; 95% CI 1.3–4.7), Gastroenterology Outpatient Clinics 29.5%/11.5% (OR 3.2; 95% CI 1.2–8.4) and Hospital Admission 25.6%/7.3% (OR 4.3; 95% CI 1.1–16.9). Figure 3 shows the distribution of the most frequently misdiagnosed pathologies prior to IBD diagnosis. Conclusion Delayed diagnosis of IBD in women affects both CD and CU, due to a longer delay in the diagnostic process since the patient consults for the first time. Gender biases in the misdiagnosis of IBD patients occur at all levels of health care.

Gender differences in clinical presentation and illicit substance use during first episode psychosis: a natural language processing, electronic case register study

ObjectiveTo determine whether gender differences in symptom presentation at first episode psychosis (FEP) remain even when controlling for substance use, age and ethnicity, using natural language processing applied to electronic...

Gender differences in clinical presentation, treatment, and outcomes in mycosis fungoides

To the Editor: Mycosis fungoides (MF) comprises 54% of cutaneous T-cell lymphomas.1 Although the etiology is unknown, prior studies found that MF is more common in men than in women with greater incidence in African Americans.1 Less is known about the clinical presentation, treatment, and prognostic factors by gender and how these factors influence survival.2,3 Previous studies have had conflicting results regarding the role of gender in survival in MF.1,4 We aim to analyze the gender differences in clinical presentation and outcomes in MF using the National Cancer Database (NCDB).

350. Neurocysticercosis – Gender Differences in Clinical Presentations

BackgroundNeurocysticercosis is a Neglected Tropical Disease and an important public health issue. Our goal was to collect and analyze data regarding clinically significant gender differences among our Neurocysticercosis patients.MethodsA retrospective chart search with ICD 9/ ICD 10 diagnostic code for Neurocysticercosis and neuroimaging suggestive of Neurocysticercosis was performed for clinical encounters in the hospital or affiliated clinics between years 2013–2018. After a careful chart review, patients who were clinically diagnosed with Neurocysticercosis were included in the study. T-test was used to compare means of continuous variables and chi-square test to compare proportions of categorical variables.ResultsAmong 90 total patients included, male (49.4%) and female (50.6%) distribution were nearly identical. The mean age in females was found to be higher than males (52.5 vs 42.0, P < 0.0001). Almost an equal number of males and females presented with either seizures (63.6% vs 57.8%, P= 0.85), headaches (25.0% vs 28.9%, p= 0.85), or other symptoms (11.4% vs 13.3%, p= 0.85). Males had more generalized seizures compared to females (60% vs 38%, P= 0.37), although this result was not statistically significant. Females were more likely to present with > 1 lesion (82.2% vs 56.8%, P= 0.01). Males were more likely to have cystic lesions (64.7% vs 27.9%, P < 0.001) compared to females who had more calcified lesions on presentation (65.1% vs 20.6%, P < 0.001). Male patients were more likely to have contrast enhancement or edema surrounding the lesions (61.4% vs 33.3%, P= 0.01) and were more likely to require treatment with Albendazole/Praziquantel (75.8% vs 31.7%, P < 0.001).ConclusionAlthough previously reported data is limited, there is a suggestion that there are gender differences in host immune response and that inflammation surrounding parenchymal lesions is more intense in females. This study suggests that men either present early in the disease phase or have different immune responses than women and require anti-parasitic therapy more frequently. More research in this aspect is needed.Disclosures All Authors: No reported disclosures

Platelet-rich plasma for genital lichen sclerosus: analysis and results of 94 patients. Are there gender-related differences in symptoms and therapeutic response to PRP?

Background Lichen sclerosus is a chronic relapsing inflammatory dermatosis with a predilection for anogenital skin in 85%–98% of cases and is more prevalent in women (3%) than in men (> 0.07%). Objectives The purpose of this study was to investigate gender differences in clinical presentation and therapeutic response to treatment with platelet-rich plasma (PRP), an emerging innovative strategy for LS. Methods Forty-three male and 51 female patients affected by LS were evaluated. Each patient was subjected to PRP treatment (1 infiltration every 15 days, for 3 times). Results The PRP procedure was well tolerated by all patients and an overall significant decrease in symptoms was reported 6 months after PRP infiltration. Reduction in pain and burning sensation was significant in both gender but more accentuated in women than in men, whereas reduction of itching was similar. On the contrary, dyspareunia evidenced sex-related difference since a significant diminution was observed only in male. Conclusions This study demonstrates that PRP based therapy may exert a relevant role in LS patient management due to its effect on Quality of Life (QoL) and sexual function in both gender. In addition, the study underlined gender-related differences in severity of symptoms and disease age onset.

Gender differences in clinical presentation and prognosis of thyroid eye disease.

To examine the clinical differences in manifestation, treatment, and prognosis of thyroid-eye-disease (TED) between men and women. This is a longitudinal cohort study. Men and women, who diagnosed with TED and treated at a multidisciplinary TED clinic, were compared regarding differences in demographics, eye examination, disease activity, and quality of life evaluation. TED was diagnosed in 132 patients during the study period, and they included 38 men (28.78%) and 94 women (71.21%). There were six men and 20 women with active disease (Clinical-Activity-Score (CAS) ⩾ 3) during the entire follow-up period (p < 0.01). The mean time from TED diagnosis to CAS ⩾ 3 was 4.50 years for men and 2.35 years for women (p = 0.05). There were no significant differences in mean total Graves' Orbitopathy-Quality-of-Life questionnaire (GO-QOL) score. However, mean GO-QOL subtotal score of external appearance of women was significantly lower compare to men in the first and last visit (p = 0.04, 0.03, respectively). Active disease was more common in women and the time-from-diagnosis of TED to CAS ⩾ 3 was shorter among women. Moreover, the appearance QOL score of women was poorer. These findings should be taken into consideration when planning the timing of treatment and when choosing the best treatment for TED patients.

Gender differences in clinical presentation among treatment-seeking Veterans and Canadian Armed Forces personnel

Introduction: Limited research has investigated gender differences among treatment-seeking Veterans and serving military personnel, despite important implications for treatment provision. In order to better serve the needs of women with military service, the authors sought to address this gap by examining the clinical presentation of men and women requesting services for military-related operational stress injuries (OSIs). Methods: Using a sample of 648 treatment-seeking male ( n = 550) and female ( n = 99) Veterans and Canadian Armed Forces (CAF) personnel, the authors compared prevalence of childhood sexual and physical abuse, probable mental health diagnoses (posttraumatic stress disorder [PTSD], depression, and generalized anxiety disorder [GAD]), and severity of pain and somatic symptoms. Results were rerun to control for sociodemographic variables that significantly differed by gender. Results: Rates of probable PTSD were higher for women ( p &lt; 0.05), and women reported significantly more somatic symptoms ( p &lt; 0.001), pain severity ( p &lt; 0.01), and childhood sexual abuse (47% of the sample; p &lt; 0.001). Both men and women reported equally high rates of childhood physical abuse (71% for both genders). Discussion: Women in this study had a higher prevalence of probable PTSD and childhood sexual abuse, and reported higher severity of pain and somatic symptoms. The study highlights the diverse range of issues that are clinically relevant for – and may complicate the treatment of – women with military service who have OSIs.

Is There a Gender Difference in Clinical Presentation of Renal Hyperparathyroidism and Outcome after Parathyroidectomy?

Introduction: Gender has been proven to influence the pathophysiology and treatment of numerous diseases, including kidney diseases and hormonal dysfunction like hyperparathyroidism. Thus, higher parathormone levels have been demonstrated in women with end-stage kidney disease, when compared to men. Objectives: We questioned whether female gender is associated with an increased risk for parathyroid nodular hyperplasia and necessary parathyroidectomy in dialysis patients and assessed demographics as well as outcome data for women and men undergoing parathyroidectomy for renal hyperparathyroidism. Patients and Methods: One hundred and thirty patients (men = 75, female = 55) with end-stage renal disease on chronic dialysis and advanced secondary hyperparathyroidism who underwent parathyroidectomy between 2008 and 2014 at our center were analyzed retrospectively. Perioperative characteristics and short-term outcome were evaluated with respect to biological gender. Results: No differences could be demonstrated for patient demography, comorbidities and the perioperative course between males and females. Only preoperative calcium levels were lower in female than in male patients (2.3 ± 0.19 vs. 2.3 ± 0.26, p = 0.04). There were more women, however, with cerebrovascular complications during follow-up (p = 0.04). There was no postoperative mortality, and all complications and comorbidities with exception of cerebrovascular diseases were equally distributed between female and male patients. Conclusion: Overall, we could not demonstrate many significant differences between male and female patients with end-stage renal diseases, chronic dialysis and operated secondary hyperparathyroidism. Only preoperative electrolyte levels were higher in male than in female patients, and cerebrovascular complications developed more often in females than in males during long-term follow-up.

Gender Differences in Clinical Presentation and Treatment Outcomes in Aggressive Tall Cell Papillary Thyroid Carcinoma in A Large, Single Institution Experience

Papillary thyroid carcinoma (PTC) with tall cell morphology (TCM) is an aggressive variant associated with poorer outcomes compared to classical PTC. There is a suggestion that men with PTC have poorer outcomes than women. We sought to explore gender differences in presentation and outcomes for PTC with TCM in a large, single institution cohort. From an IRB approved registry, we identified all cases of PTC with TCM at our institution with patient, tumor, treatment data and outcomes from January 1997 to July 2018. Tall Cell Variant (TCV) PTC had ≥30% TCM while Tall Cell Features (TCF) had <30% TCM. Pts with any other coexisting aggressive morphology/histology or no surgery were excluded. Demographic & clinico-pathologic features at the time of TCM diagnosis that were potentially associated with 10-yr locoregional recurrence free survival (LRFS), distant recurrence free survival (DRFS) and overall survival (OS) were evaluated using Kaplan-Meir (KM) method and Cox proportional hazard model. A total of 365 pts with TCM (32% TCV; 68% TCF) PTC were evaluable. There were 123 (34%) males and 242 (66%) females. At time of TCM diagnosis, age (mean 53 yo vs 51 yo, p=0.13), pT3/T4 (69.7% vs 62.0%, p=0.15), distant metastatic disease (4.1% vs 1.2%, p=0.08), positive surgical margins (p=0.22), and TCM (p=0.65) were similar. Males had more pN+ disease (62.6% vs 47.5%, p=0.006), larger primary tumor diameter (mean 2.8 cm vs 1.8 cm, p<0.001), and a higher positive lymph node count (5.7 vs 2.8, p<0.001). KM estimated 5-yr LRFS (72.9% vs 86.2%, p=0.003), 5-yr DRFS (82.8% vs 97.4%, p<0.001), and 5-yr OS (87.1% vs 96.3%, p=0.004) were significantly worse in males. After adjusting for clinical features, the risks of recurrence and OS were similar between male and female. In this large, single institution experience of PTC with TCM, males had worse outcomes than females. This difference was attributed to worse pathologic features at presentation in males. Further validation of this finding in a larger multi-institutional cohort is warranted.

Gender differences in clinical presentation and vascular pattern in patients with Takayasu arteritis

Objective: To compare clinical characteristics and pattern of vascular involvement at disease onset according to gender specificity in patients with Takayasu arteritis (TA).Methods: Data from 117 TA patients (11 male, 106 female), diagnosed according to the American College of Rheumatology criteria, from our centre were retrospectively collected. Differences between men and women regarding demographic features, diagnostic delay, signs and symptoms attributed to TA, and arteries involved at diagnosis were compared. Data were obtained from three published articles describing gender differences in TA. A global analysis of these three cohorts plus ours (a total of 578 patients; 108 men, 470 women) was performed.Results: In our TA cohort, age at disease onset and age at diagnosis were not significantly different between genders. Diagnostic delay was higher in men. Male patients showed higher involvement of iliac arteries (right, p = 0.016; left, p = 0.021); females suffered more frequently from upper limb claudication (p = 0.026). In the overall analysis, men had higher prevalence of arterial hypertension (p = 0.007) and more frequent involvement of abdominal aorta (p = 0.026), renal arteries (right, p < 0.001; left, p < 0.001), and iliac arteries (right, p = 0.009; left, p = 0.002). Women more frequently exhibited upper limb claudication (p = 0.042) and involvement of left subclavian artery (p = 0.005), carotid arteries (right, p < 0.001; left, p < 0.001), and supradiaphragmatic aorta (ascending, p = 0.050; arch, p < 0.001; descending, p = 0.003). Inflammatory markers were more frequently raised in women (p = 0.005).Conclusions: In TA patients, gender has a strong influence on pattern of vascular involvement and consequently on clinical presentation. Specifically, women have a higher involvement of the supradiaphragmatic vessels, whereas in men the abdominal vessels are more frequently affected.

Abstract 17356: Gender Differences in Clinical Presentation and Outcomes of Patients With Acute Myocardial Infarction and Spontaneous Coronary Artery Dissection: A Nationwide Inpatient Sample Matched Analysis

Introduction: Spontaneous Coronary Artery Dissection (SCAD) is reported to occur predominantly in young women. Gender differences in the clinical presentation and outcomes of patients with SCAD have not been studied on a population level. We sought to compare the in-hospital outcomes of men and women presenting with acute myocardial infarction (AMI) and SCAD. Methods: We identified patients from the National Inpatient Sample (NIS) between 2005 and 2015 who presented with primary diagnoses of AMI and SCAD. We identified SCAD with ICD-9 code 414.12. A 1:1 propensity-matched cohort was created to examine the outcomes between men and women. Primary endpoint was in-hospital mortality. Secondary endpoints included in-hospital cardiac and non-cardiac complications. Results: Of the 6617 (32017 weighted national estimates) patients with SCAD over the study period, majority were males 3667 (55.4%). Males were younger than females (60.32 yr vs. 61.59 yr) and presented more often with ST-elevation myocardial infarction (STEMI) (53.0% vs. 45.9% P=&lt;0.001). Propensity matching yielded 2366 males and 2366 females. In the matched group, there was no significant difference in in-hospital mortality between males and females (OR 1.20 95% CI -0.93-1.54). With regards to in-hospital complications, ventricular tachycardia (V-Tach) was significantly less frequent in females as compared to males (8.0% vs. 10.1% OR 0.76 p-value 0.003). There was no significant difference between females and males in the frequency of other complications, including intracranial hemorrhage (0.2% vs 0.2% OR 1.45 p-value 0.50), GI bleed (1.8% vs 1.3% OR 1.35 p-value 0.13), cardiogenic shock (9.8% vs 9.7% OR 1.01 p-value 0.86), acute heart failure (3% vs 2.6% OR 1.18 p-value 0.26), ventricular fibrillation(vfib) (5.6% vs 6.0% OR 0.928 p-value 0.48) or stroke ( 1.5% vs 1.0% OR 1.535 p-value 0.06) Conclusion: In our large population-based analysis, compared to females, males were more likely to present with STEMI as compared to females. With the except of V-Tach, which was higher in males, there were no significant gender differences in hospital outcomes namely inpatient mortality, cardiogenic, Vfib or acute heart failure.

P3634Impact of gender difference in clinical presentation on long-term outcomes in chinese patients undergoing percutaneous coronary intervention

P3634Impact of gender difference in clinical presentation on long-term outcomes in chinese patients undergoing percutaneous coronary intervention