Sex-Related Differences in the Presentation and Management of Acute Coronary Syndrome and Stable Angina in Iranian Patients

Little is known about the impact of sex-related differences on clinical presentation, treatment adherence, and outcomes in patients with acute coronary syndrome (ACS) in developing countries, such as Iran.
 
This observational cross-sectional study used the Coronary Angiography and Angioplasty Registry (CAAR) data. We included all adults who underwent coronary angiography or angioplasty within 1 year, analyzing data from 1548 cases.
 
A total of 1548 patients were included in the analysis. Women were older than men when experiencing ACS and had a higher prevalence of atypical symptoms. Women were also more likely to have comorbid conditions such as hypertension, diabetes, obesity, dyslipidemia, and depression. Still, men were more likely to have a history of smoking and previous myocardial infarction (MI). Investigation of differences regarding invasive therapeutic procedures, culprit arteries, and numbers of diseased vessels showed no significant differences between women and men in the ST-elevation myocardial infarction (STEMI) and non-STEMI groups. However, there was a significant difference between women and men in these factors in patients with unstable angina and stable angina. Men in these groups were more likely to have the involvement of 2 or 3 coronary arteries and were more likely to be recommended for percutaneous coronary intervention and coronary artery bypass graft surgery. Nonetheless, there was no significant difference in acceptance rates of recommended treatment in these groups between men and women.
 
The study findings provide insight into the differences between male and female ACS patients in the Iranian population, highlighting the need for sex-specific approaches in treatment. (Iranian Heart Journal 2024; 25(3): 58-71)