TY - JOUR
T1 - Sex Differences in Acute Coronary Syndromes
T2 - A Scoping Review Across the Care Continuum
AU - Marzà-Florensa, Anna
AU - Kiss, Pauline
AU - Youssef, Dina Mohamed
AU - Jalali-Farahani, Sara
AU - Lanas, Fernando
AU - di Cesare, Mariachiara
AU - González Juanatey, José Ramón
AU - Taylor, Sean
AU - Uijl, Alicia
AU - Grobbee, Diederick E
AU - Des Rosiers, Sarah
AU - Perel, Pablo
AU - Peters, Sanne A E
N1 - Publisher Copyright:
© 2025 The Author(s).
PY - 2025/3/11
Y1 - 2025/3/11
N2 - 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 30th, 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.
AB - 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 30th, 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.
KW - Acute Coronary Syndrome/therapy
KW - Continuity of Patient Care
KW - Female
KW - Healthcare Disparities
KW - Humans
KW - Male
KW - Sex Factors
U2 - 10.5334/gh.1410
DO - 10.5334/gh.1410
M3 - Review article
C2 - 40094068
SN - 2211-8160
VL - 20
JO - Global Heart
JF - Global Heart
IS - 1
M1 - 26
ER -