Gender differences in acute coronary syndromes patterns during the COVID-19 outbreak.
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Barbero Umberto, Moncalvo Cinzia, Trabattoni Daniela, Pavani Marco, Amoroso Gisella Rita, Bocchino Pier Paolo, Truffa Giachet Alessandra, Saglietto Andrea, Monticone Silvia, Secco Gioel Gabrio, Campo Gianluca, Verardi Roberto, Iannaccone Mario, Galvani Marcello, Ugo Fabrizio, Infantino Vincenzo, Olivotti Luca, Mennuni Marco, Vercellino Matteo, Gili Sebastiano, Zucchetti Ottavio, Casella Gianni, Giammaria Massimo, De Benedictis Michele, Tolomeo Paolo, Doronzo Baldassarre, Grosso Marra Walter, Rognoni Andrea, Montefusco Antonio, Patti Giuseppe, Mancone Massimo, De Ferrari Gaetano Maria, D'Ascenzo Fabrizio
Аннотация
METHODS: We performed a retrospective analysis of clinical and angiographic characteristics of consecutive patients who were admitted for ACS at 15 hospitals in Northern Italy comparing men and women data. The study period was defined as the time between the first confirmed case of Covid-19 in Italy (February 20, 2020) and March 31, 2020. We compared hospitalization rates between the study period and two control periods: the corresponding period during the previous year (February 20 to March 31, 2019) and the earlier period during the same year (January 1 to February 19, 2020). Incidence rate ratios comparing the study period with each of the control periods were calculated with the use of Poisson regression.
RESULTS: Of the 547 patients who were hospitalized for ACS during the study period, only 127 (23%) were females, accounting for a mean of 3.1 admissions per day, while ACS hospitalized males were 420, with a mean of 10.2 admissions per day. There was a significant decrease driven by a similar reduction in ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) diagnosis in both sexes compared to the control periods. A trend toward a greater reduction in admitted females was shown in the intra-year control period (46% admission reduction in females vs 37% in males, with females accounting for 26% of ACS, P=0.10) and a significant reduction when compared to the previous year control period (40% admission reduction in females vs 23% in males, with females accounting for 28% of ACS, P=0.03), mainly related to Unstable Angina diagnosis.
CONCLUSION: The Covid-19 pandemic period closed the gap between men and women in ACS, with similar rates of reduction of hospitalized STEMI and NSTEMI and a trend toward greater reduction in UA admission among women. Furthermore, many typical differences between males and females regarding ischemic heart disease presentations and vessel distribution were leveled.