Background: Prior studies focused on gender differences in patients with proven coronary artery disease (CAD). Less is known about these differences in subjects with acute chest pain (CP).
Methods: We enrolled 1047 consecutive patients with CP suggestive of coronary origin but with normal ECG and troponin level who were hospitalized in CP unit (CPU). Of the 865 patients without prior CAD, 578 (67%) were men and 287 (33%) women. Gender differences were compared for outcomes during hospitalization and at 90 days follow-up.
Results: Compared to men, women were older (57±11vs. 51±11, p<0.001), more likely to have hypertension (42% vs. 31%, p<0.01), dyslipidemia (54% vs. 44%, p=0.007) but less likely to be smokers (27% vs 42%, p<0.001). The time from symptoms onset to admission (14±21 vs. 15±22 hours, p=0.2) and number of CP episodes (1.4±0.9 vs. 1.6±1.2, p=0.3) were similar among women and men respectively.
The number of patients showing evidence of ACS (troponin elevation, ECG changes) during observation period were comparable between men and women (6.3% vs. 3.5%, p=0.12). Equally high proportion were referred to non-invasive tests for CAD (92% vs. 94%, p=0.3); computed tomography angiography (CTA)was performed in 93% of women and 96% of men. Women were less likely to have significant (1% vs 4.6%, p=0.009) and non-obstructive CAD (8.8% vs. 15%, p=0.012). Among patients (n=53) who further underwent invasive coronary angiography women were less likely to have significant CAD (36% vs 56%, p=0.22).
During the follow up period recurrence of CP was similar among women and men (25% vs 27%, p=0.9) but women were less likely to be readmitted (4.8% vs. 9.4%, p=0.03). The occurrence of ACS, revascularization and\or death was similar in women and men (0.9% vs. 1%, p=0.9).
Conclusions: Women with CP are evaluated as vigorously as men. Although women were older and with higher risk profile they were less likely to have ACS and\or significant CAD.
