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Sex-related characteristics in hospitalized patients with acute coronary syndromes – the Greek Study of Acute Coronary Syndromes (GREECS)

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Abstract

We studied the sex-specific distribution of various factors in hospitalized patients who presented with acute coronary syndromes (ACS), as well as the annual incidence and the in-hospital and short-term outcomes in males and females. A sample of six hospitals located in Greek urban and rural regions was selected. In these hospitals we recorded almost all nonfatal admissions with a first event of ACS, from October 2003 to September 2004. Sociodemographic, clinical, dietary, and other lifestyle characteristics were recorded. A total of 2 172 patients were included in the study (1 649, 76% male and 523, 24% female). The annual incidence rate was almost three times higher in males than in females (34 per 10 000 males and 10.9 per 10 000 females). The highest frequency of events was observed in winter, in both sexes. Females had higher in-hospital mortality rate as compared to males (5.7% vs 3.2%, P = 0.007), while the 30-day mortality and rehospitalization rate was 17% in male and 16% in female patients. The most common discharged diagnosis for males was Q-wave myocardial infraction (35%), while females were more likely to suffer from unstable angina (42%). Females were older than males, waited longer between seeking and receiving medical advice, and were more likely to have a history of hypertension, obesity, and diabetes mellitus as compared to males. On the other hand, males were more likely to be smokers, to follow a more typical Mediterranean diet, and to be more physically active (P < 0.05). We revealed a sex-related difference in the profile of clinical characteristics and other cardiovascular risk factors in hospitalized patients for ACS.

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References

  1. M Higgins (2000) ArticleTitleEpidemiology and prevention of coronary heart disease in families Am J Med 108 387–395 Occurrence Handle10759095 Occurrence Handle10.1016/S0002-9343(99)00409-X Occurrence Handle1:STN:280:DC%2BD3c3itVyntw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  2. K Miwa M Fujita S Sasayama (2005) ArticleTitleRecent insights into the mechanisms, predisposing factors, and racial differences of coronary vasospasm Heart Vessels 20 1–7 Occurrence Handle15700195 Occurrence Handle10.1007/s00380-004-0794-4

    Article  PubMed  Google Scholar 

  3. A Cerne I Kranjec (2002) ArticleTitleAtherosclerotic burden in coronary and peripheral arteries in patients with first clinical manifestation of coronary artery disease Heart Vessels 16 217–226 Occurrence Handle12382030 Occurrence Handle10.1007/s003800200028

    Article  PubMed  Google Scholar 

  4. D Wood (2001) ArticleTitleEstablished and emerging cardiovascular risk factors Am Heart J 141 49–57 Occurrence Handle10.1067/mhj.2001.109951

    Article  Google Scholar 

  5. D Hasdai S Behar L Wallentin N Danchin AK Gitt E Boersma PM Fioretti ML Simoons A Battler (2002) ArticleTitleA prospective survey of the characteristics. Treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS) Eur Heart J 23 1190–1201 Occurrence Handle12127921 Occurrence Handle10.1053/euhj.2002.3193 Occurrence Handle1:STN:280:DC%2BD38zotFyhtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  6. DJ Lerner WB Kannel (1986) ArticleTitlePatterns of coronary heart disease morbidity and mortality in the genders: a 26-year follow-up of the Framingham population Am Heart J 111 383–390 Occurrence Handle3946178 Occurrence Handle10.1016/0002-8703(86)90155-9 Occurrence Handle1:STN:280:BimC38npsFI%3D

    Article  PubMed  CAS  Google Scholar 

  7. CH Hennekens (1998) ArticleTitleRisk factors for coronary heart disease in women Cardiol Clin 1 1–8 Occurrence Handle10.1016/S0733-8651(05)70378-7

    Article  Google Scholar 

  8. C Chrysohoou DB Panagiotakos C Pitsavos P Kokkinos N Marinakis C Stefanadis PK Toutouzas (2003) ArticleTitleGender differences on the risk evaluation of acute coronary syndromes: the CARDIO2000 study Prev Cardiol 6 71–77 Occurrence Handle12732792

    PubMed  Google Scholar 

  9. R Jackson L Chambless M Higgins K Kuulasmaa L Wijnberg D Williams InstitutionalAuthorNameWHO MONICA Project and ARIC Study (1997) ArticleTitleGender difference in ischemic heart disease mortality and risk factors in 46 communities: an ecologic analysis Cardiovasc Risk Factors 7 43–54

    Google Scholar 

  10. ML Brochier P Arwidson (1998) ArticleTitleCoronary heart disease risk factors in women Eur Heart J Suppl A A45–52

    Google Scholar 

  11. RM Robertson (2001) ArticleTitleWomen and cardiovascular risk Circulation 103 2318–2320 Occurrence Handle11352875 Occurrence Handle1:STN:280:DC%2BD3M3ptVWisQ%3D%3D

    PubMed  CAS  Google Scholar 

  12. A Dontas (1994) Recent trends in cardiovascular disease and risk factors in the Seven Countries Study: Greece H Toshima Y Koga H Blackburn A Keys (Eds) Lessons for science from the Seven Countries Study Springer Berlin Heidelberg New York Tokyo

    Google Scholar 

  13. GK Andrikopoulos DJ Richter PE Dilaveris A Pipilis A Zaharoulis JE Gialafos PK Toutouzas ET Chimonas (2001) ArticleTitleIn-hospital mortality of habitual cigarette smokers after acute myocardial infarction; the "smoker's paradox" in a countrywide study Eur Heart J 22 776–784 Occurrence Handle11350110 Occurrence Handle10.1053/euhj.2000.2315 Occurrence Handle1:STN:280:DC%2BD3M3lt1CntQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  14. DB Panagiotakos C Pitsavos C Chrysohoou C Stefanadis PK Toutouzas (2001) ArticleTitleRisk stratification of coronary heart disease through established and emerging lifestyle factors, in a Mediterranean population: CARDIO2000 epidemiological study J Cardiovasc Risk 6 329–339 Occurrence Handle10.1097/00043798-200112000-00001

    Article  Google Scholar 

  15. Myocardial infarction redefined a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Eur Heart J 2000;21:1502–1513

  16. E Braunwald (1997) Heart disease EditionNumber5th edn. Saunders London

    Google Scholar 

  17. World Health Organization (1997) Obesity: preventing and managing the global epidemic. Report of a WHO Consultation, presented at the World Health Organization. Publication WHO/NUT/NCD/98.1, Geneva, Switzerland

  18. RR Pate M Pratt SN Blair WL Haskell CA Macera C Bouchard D Buchner W Ettinger GW Heath AC King (1995) ArticleTitlePhysical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine JAMA 273 402–407 Occurrence Handle7823386 Occurrence Handle10.1001/jama.273.5.402 Occurrence Handle1:STN:280:ByqC38zntFE%3D

    Article  PubMed  CAS  Google Scholar 

  19. WC Willett F Sacks A Trichopoulou G Drescher A Ferro-Luzzi E Helsing D Trichopoulos (1995) ArticleTitleMediterranean diet pyramid: a cultural model for healthy eating Am J Clin Nutr 6 1402S–1406S

    Google Scholar 

  20. C Pitsavos DB Panagiotakos A Antonoulas S Zombolos Y Kogias Y Mantas P Stravopodis G Kourlaba C Stefanadis InstitutionalAuthorNameGreek study of acute Coronary Syndromes study investigators (2005) ArticleTitleEpidemiology of acute coronary syndromes in a Mediterranean country; aims, design and baseline characteristics of the Greek study of acute coronary syndromes (GREECS) BMC Publ Health 5 23 Occurrence Handle10.1186/1471-2458-5-23

    Article  Google Scholar 

  21. AI Papathanasiou KD Pappas P Korantzopoulos JP Leontaridis TG Vougiouklakis M Kiriou V Dimitroula LK Michalis JA Goudevenos (2004) ArticleTitleAn epidemiologic study of acute coronary syndromes in north-western Greece Angiology 55 187–194 Occurrence Handle15026874 Occurrence Handle10.1177/000331970405500211 Occurrence Handle1:STN:280:DC%2BD2c7jtlajtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  22. ET Chimonas (2001) ArticleTitleThe treatment of coronary heart disease: an update. Part 2: mortality trends and main causes of death in the Greek population Curr Med Res Opin 17 27–33 Occurrence Handle11464442 Occurrence Handle10.1185/03007990152005315 Occurrence Handle1:STN:280:DC%2BD38%2Fit12rtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  23. A Rosengren L Wallentin A Gitt S Behar A Battler D Hasdai (2004) ArticleTitleGender, age, and clinical presentation of acute coronary syndromes Eur Heart J 25 663–670 Occurrence Handle15084371 Occurrence Handle10.1016/j.ehj.2004.02.023

    Article  PubMed  Google Scholar 

  24. TJ Bowker RM Turner DA Wood TL Roberts N Curzen M Gandhi SG Thompson KM Fox (2000) ArticleTitleon behalf of the SAMII Study Group. A national Survey of Acute Myocardial Infarction and Ischaemia (SAMII) in the UK: characteristics, management and in-hospital outcome in women compared to men in patients under 70 years Eur Heart J 21 1458–1463 Occurrence Handle10952838 Occurrence Handle10.1053/euhj.2000.2237 Occurrence Handle1:STN:280:DC%2BD3M%2Fis12muw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  25. V Vaccarino L Parsons NR Every HV Barron HM Krumholz (1999) ArticleTitleGender-based differences in early mortality after myocardial infarction. National Registry of Myocardial Infarction 2 Participants N Engl J Med 341 217–225 Occurrence Handle10413733 Occurrence Handle10.1056/NEJM199907223410401 Occurrence Handle1:STN:280:DyaK1MzivVCqsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  26. JS Hochman JE Tamis TD Thompson WD Weaver HD White F Van de Werf P Aylward EJ Topol RM Califf (1999) ArticleTitleGender, clinical presentation, and outcome in patients with acute coronary syndromes. Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes IIb investigators N Engl J Med 341 226–232 Occurrence Handle10413734 Occurrence Handle10.1056/NEJM199907223410402 Occurrence Handle1:STN:280:DyaK1MzivVCqsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  27. A Di Chiara C Fresco S Savonitto C Greco D Lucci L Gonzini A Mafrici F Ottani L Bolognese S De Servi A Boccanelli AP Maggioni F Chiarella (2006) ArticleTitleBLITZ-2 Investigators. Epidemiology of non-ST elevation acute coronary syndromes in the Italian cardiology network: the BLITZ-2 study Eur Heart J 27 393–405 Occurrence Handle16219657 Occurrence Handle10.1093/eurheartj/ehi557

    Article  PubMed  Google Scholar 

  28. EL Eisenstein DK McGuire MV Bhapkar A Kristinsson JS Hochman DF Kong RM Califf F Van de Werf WS Yancy SuffixJr LK Newby (2005) ArticleTitleElevated body mass index and intermediate-term clinical outcomes after acute coronary syndromes Am J Med 118 981–990 Occurrence Handle16164884 Occurrence Handle10.1016/j.amjmed.2005.02.017

    Article  PubMed  Google Scholar 

  29. S Gottlieb D Harpaz A Shotan V Boyko J Leor M Cohen L Mandelzweig B Mazouz S Stern S Behar (2000) ArticleTitleGender differences in management and outcome after acute myocardial infarction in the 1990s. A prospective observational community – based study Circulation 102 2484 Occurrence Handle11076821 Occurrence Handle1:STN:280:DC%2BD3M%2FktFClug%3D%3D

    PubMed  CAS  Google Scholar 

  30. Y Uehara WS Shin T Watanabe T Osanai M Miyazaki H Kanase K Sugano T Toyo-Oka (1997) ArticleTitleRole of Y chromosome of hypertensive parent in determination of blood pressure in normotensive offspring Heart Vessels 12 156–159 Occurrence Handle9476568

    PubMed  Google Scholar 

  31. LA Leinwand (2003) ArticleTitleSex is a potent modifier of the cardiovascular system J Clin Invest 112 302–307 Occurrence Handle12897194 Occurrence Handle10.1172/JCI200319429 Occurrence Handle1:CAS:528:DC%2BD3sXmtFemsLc%3D

    Article  PubMed  CAS  Google Scholar 

  32. N Bello M Mosca (2004) ArticleTitleEpidemiology of coronary heart disease in women Prog Cardiovasc Dis 46 287–295 Occurrence Handle14961452 Occurrence Handle10.1016/j.pcad.2003.08.001

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Dietetics – Nutrition, Harokopio University, Athens, Greece

    Demosthenes B. Panagiotakos

  2. First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece

    Christos Pitsavos, Georgia Kourlaba & Christodoulos Stefanadis

  3. For the GREECS Study Investigators, Athens, Lamia, Kalamata, Halkida, Zakynthos, Karditsa, Greece

    Demosthenes B. Panagiotakos, Christos Pitsavos, Yannis Mantas, Spyros Zombolos, Yannis Kogias, Antonis Antonoulas & Petros Stravopodis

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  1. Demosthenes B. Panagiotakos
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  2. Christos Pitsavos
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  3. Georgia Kourlaba
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  4. Yannis Mantas
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  7. Antonis Antonoulas
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  9. Christodoulos Stefanadis
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Correspondence to Demosthenes B. Panagiotakos.

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Panagiotakos, D., Pitsavos, C., Kourlaba, G. et al. Sex-related characteristics in hospitalized patients with acute coronary syndromes – the Greek Study of Acute Coronary Syndromes (GREECS). Heart Vessels 22, 9–15 (2007). https://doi.org/10.1007/s00380-006-0932-2

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  • DOI: https://doi.org/10.1007/s00380-006-0932-2

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