The rate of hospitalization for acute coronary syndrome (ACS) among young patients is increasing. Healthcare disparities remain unsolved among female patients. We explored gender differences regarding risk factors, clinical presentation, in-hospital treatment, and long-term outcomes among ACS patients. A total of 445 patients with very early ACS (men ≤ 35 years and women ≤ 40 years of age) were followed for a median of 5 years. Primary clinical endpoint was the composite of cardiac death, non-fatal myocardial infarction, stroke, and coronary revascularization. Women accounted for 16% of cases. Smoking was the most prevalent risk factor, 56% and 60% of the females and males, respectively, continued to smoke after ACS. Chest pain was typical in 85% and 83% of the female and male patients, respectively. In-hospital treatment (pharmacological and reperfusion) as well as the composite clinical endpoint during follow-up did not differ between female and male patients. Lipid-lowering therapy was suboptimal in both genders, and persistence of smoking was the sole predictor for the composite clinical endpoint (hazard ratio: 2.30 [95% CI: 1.26–4.20]; P = .007). In conclusion, in-hospital treatment was similar between male and female patients. However, the majority of them continued smoking, and this was an independent predictor for future adverse outcomes.

中文翻译：

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年轻急性冠脉综合征患者的性别差异：STAMINA 研究的长期随访

年轻患者因急性冠状动脉综合征（ACS）住院的比例正在增加。女性患者的医疗保健差异仍未解决。我们探讨了 ACS 患者在危险因素、临床表现、住院治疗和长期结局方面的性别差异。共有 445 名极早期 ACS 患者（男性≤ 35 岁，女性≤ 40 岁）接受了中位随访 5 年。主要临床终点是心源性死亡、非致命性心肌梗死、卒中和冠状动脉血运重建的复合终点。女性占病例的 16%。吸烟是最普遍的危险因素，分别有 56% 和 60% 的女性和男性在 ACS 后继续吸烟。女性和男性患者中分别有 85% 和 83% 的患者出现典型胸痛。女性和男性患者的住院治疗（药理学和再灌注）以及随访期间的复合临床终点没有差异。两种性别的降脂治疗均未达到最佳效果，持续吸烟是复合临床终点的唯一预测因素（风险比：2.30 [95% CI：1.26–4.20]；P = .007）。总之，男性和女性患者的住院治疗相似。然而，他们中的大多数人继续吸烟，这是未来不良后果的独立预测因素。