Sex Differences in Acute Coronary Syndromes: A Scoping Review Across the Care Continuum.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Global Heart Pub Date : 2025-03-11 eCollection Date: 2025-01-01 DOI:10.5334/gh.1410

Anna Marzà-Florensa, Pauline Kiss, Dina Mohamed Youssef, Sara Jalali-Farahani, Fernando Lanas, Mariachiara di Cesare, José Ramón González Juanatey, Sean Taylor, Alicia Uijl, Diederick E Grobbee, Sarah Des Rosiers, Pablo Perel, Sanne A E Peters

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引用次数: 0

Abstract

Introduction: Optimal diagnosis and management of acute coronary syndrome (ACS) is essential to improve clinical outcomes and prognosis. Sex disparities in ACS care have been reported in the literature, but evidence gaps remain. This review aims to map and to summarize the global evidence on sex differences in the provision of care across the ACS continuum.

Methods: A systematic literature search was conducted in Pubmed, EMBASE, and the World Health Organization Global Index Medicus. The search was restricted to original research articles published between January 1, 2013, and August 30^th, 2023, and with a full-text available in English, Spanish, Dutch, or French. The search terms and key words covered five aspects of the ACS care continuum: pre-hospital care, diagnosis, treatment, in-hospital events, and discharge.

Results: Of the 15,033 identified articles, 446 articles (median percentage of women per study: 29%), reporting on 1,483 outcomes, were included. Most studies were conducted in high-income regions (65%). Studies reported on pre-hospital care (8%), diagnosis (9%), treatment (45%), discharge (14%) and events (24%). For 45% of outcomes, results favored men, 5% favored women, and 50% showed mixed results or no sex difference. ACS care aspects with the largest sex differences were pre-hospital care (58% of the outcomes favored men vs 7% favored women) and diagnosis (70% favored men vs 2% favored women).

Conclusion: Studies on sex differences in ACS mainly come from high-income regions. Sex differences in ACS management are widely reported and mainly unfavorable to women, especially in the early phases of pre-hospital care and diagnosis.

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急性冠状动脉综合征的性别差异：贯穿护理连续体的范围审查。

摘要：急性冠脉综合征（ACS）的最佳诊断和治疗对于改善临床结果和预后至关重要。文献中已经报道了ACS治疗中的性别差异，但证据差距仍然存在。本综述旨在绘制和总结ACS连续体中提供护理的性别差异的全球证据。方法：系统检索Pubmed、EMBASE和世界卫生组织全球医学索引。检索仅限于2013年1月1日至2023年8月30日之间发表的原创研究文章，并提供英语，西班牙语，荷兰语或法语的全文。检索词和关键词涵盖了ACS护理连续体的五个方面：院前护理、诊断、治疗、院内事件和出院。结果：在15033篇确定的文章中，446篇（每项研究中女性比例中位数为29%），报告了1483个结果，被纳入。大多数研究是在高收入地区进行的（65%）。研究报告了院前护理（8%）、诊断（9%）、治疗（45%）、出院（14%）和事件（24%）。45%的结果对男性有利，5%的结果对女性有利，50%的结果好坏参半或没有性别差异。性别差异最大的ACS护理方面是院前护理（58%的结果有利于男性，7%的结果有利于女性）和诊断（70%的结果有利于男性，2%的结果有利于女性）。结论：ACS的性别差异研究主要来自高收入地区。ACS管理的性别差异被广泛报道，主要对女性不利，特别是在院前护理和诊断的早期阶段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.