INTRODUCTION Gender-related differences in the treatment of patients with non-ST elevation myocardial infarction (NSTEMI) have been reported in many previous studies despite the fact that an equal approach is recommended in all current guidelines. The aim of the study was to investigate whether gender-related discrepancies in the management of NSTEMI patients have changed. MATERIAL AND METHODS Between 2012 and 2014 a total of 66,667 patients (38.3% of whom were women) with the final diagnosis of NSTEMI were included into the retrospective analysis of the Polish Registry of Acute Coronary Syndromes (PL-ACS). Differences in clinical profile, treatment, and outcomes were analysed. RESULTS Women were older than men and more often had comorbidities. They were less likely to undergo coronary angiography (88.4% vs. 92.1%, p < 0.05) as well as percutaneous coronary intervention (59.6% vs. 71.9%, p < 0.05). In the general population women had also significantly worse in-hospital prognosis as well as in 12-month follow-up. After the age adjustment the outcomes in women were at least as good as in men. In multivariate analysis females had the same risk as men in-hospital RR = 1.02 (95% CI: 0.97-1.08, p = 0.45) and lower in 12-month observation RR = 0.94 (95% CI: 0.92-0.97, p < 0.0001). CONCLUSIONS In comparison with previous reports on NSTEMI patients, gender-related disparities in the treatment and outcomes were radically reduced. Unadjusted mortality rates were still higher in women as a consequence of their older age. After the age adjustment, mortality ratios were similar in both genders. The long-term prognosis seems to be even better in women.

中文翻译：

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非 ST 段抬高型心肌梗死患者的治疗和结果中与性别相关的差异：2012-2014 年波兰急性冠状动脉综合征登记处 (PL-ACS) 的结果。


引言 尽管所有现行指南都推荐采用相同的方法，但许多先前的研究已经报告了非 ST 段抬高型心肌梗死 (NSTEMI) 患者治疗中与性别相关的差异。该研究的目的是调查 NSTEMI 患者治疗中与性别相关的差异是否发生了变化。材料和方法 2012 年至 2014 年间，共有 66,667 名最终诊断为 NSTEMI 的患者（其中 38.3% 为女性）被纳入波兰急性冠状动脉综合征登记处 (PL-ACS) 的回顾性分析。分析了临床特征、治疗和结果的差异。结果 女性比男性年龄大，并且更容易患有合并症。他们不太可能接受冠状动脉造影（88.4% vs. 92.1%，p < 0.05）以及经皮冠状动脉介入治疗（59.6% vs. 71.9%，p < 0.05）。在一般人群中，女性的院内预后以及 12 个月的随访结果也明显较差。年龄调整后，女性的结果至少与男性一样好。在多变量分析中，女性住院风险与男性相同，RR = 1.02（95% CI：0.97-1.08，p = 0.45），并且在 12 个月观察中较低，RR = 0.94（95% CI：0.92-0.97，p %） 3C 0.0001）。结论 与之前关于 NSTEMI 患者的报告相比，治疗和结果方面的性别相关差异大大减少。由于女性年龄较大，未经调整的死亡率仍然较高。年龄调整后，两性的死亡率相似。女性的长期预后似乎更好。