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Mohamed, MO ORCID: https://orcid.org/0000-0002-9678-5222, Rashid, M
ORCID: https://orcid.org/0000-0001-9725-1583, Timmis, A, Clarke, S, Michos, E, Kwok, CS
ORCID: https://orcid.org/0000-0001-7047-1586, de Belder, M, Valgimigli, M and Mamas, M
ORCID: https://orcid.org/0000-0001-9241-8890
(2021)
SEX DIFFERENCES IN DISTRIBUTION, MANAGEMENT AND OUTCOMES OF COMBINED ISCHEMIC-BLEEDING RISK FOLLOWING ACUTE CORONARY SYNDROME.
Journal of the American College of Cardiology, 77 (18 (S1).
39 - 39.
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S0735-1097(21)01398-X.pdf - Published Version Download (278kB) | Preview |
Abstract
Background: Risk factors of bleeding and recurrent ischemic events after acute coronary syndrome (ACS) often overlap. Whether the distribution and management of these complications vary by sex remains unknown. Methods: ACS hospitalizations in the United Kingdom between 2010 and 2017 were retrospectively analyzed, stratified by sex and bleeding-ischaemic risk combination (using CRUSADE and GRACE scores). Regression analyses were performed to examine the association between risk-groups and receipt of percutaneous coronary intervention (PCI) and dual antiplatelet therapy (DAPT) on discharge, as well as in-hospital clinical outcomes. Results: Out of 584,360 patients, a third of males (32.3%) and females (32.6%) were in the dual high bleeding-ischemic risk group. Dual high-risk patients of both sexes were less likely to receive PCI and DAPT, with a significant increase in odds of MACE, allcause and cardiac mortality, and bleeding (see figure), with the greatest difference between sexes observed in the dual-high risk group in which females were less likely to receive guideline-recommended therapy (PCI and DAPT) and more likely to experience adverse outcomes. Conclusion: ACS patients with dual high bleeding-ischemic risk are less likely to receive guideline-recommended therapy and experience significantly worse outcomes, especially in females. Novel strategies are needed to effectively manage this highly prevalent and complex patient group and address the under-treatment of females.
Item Type: | Article |
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Additional Information: | Copyright © 2021, The Author. Published by Elsevier on Behalf of The American College of Cardiology Foundation. This is an Open Access Article under the CC BY-NC-ND License (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
Subjects: | R Medicine > RC Internal medicine > RC705 Diseases of the respiratory system |
Related URLs: | |
Depositing User: | Symplectic |
Date Deposited: | 17 Jun 2021 08:07 |
Last Modified: | 17 Jun 2021 08:07 |
URI: | https://eprints.keele.ac.uk/id/eprint/9748 |
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