Gender differences in acute coronary syndromes: Do they count?

Aim: INTRODUCTION: We investigated the different control of cardiovascular risk factors such as total cholesterol, LDL, HDL, apolipoprotein A, apolipoprotein B, apolipoprotein B/A1 ratio and Lp (a) at the onset of atherosclerotic disease in male and females. Methods: We consecutively enrolled 539 patients admitted to our Coronary Care Unit (CCU) with diagnosis of Acute Coronary Syndrome (ACS) (STEMI, NSTEMI, Unstable Angina) confirmed by a coronary angiography showing obstructive lesions (> 75%). We then divided this population into two groups: 1 (men) and 2 (women). Results: In the sample analyzed, 77% of patients are men and 23% women. Women are older than men at the onset of ischemic heart disease or during relapse. Probably because older,women are more often hypertensive (83% vs 63%), diabetics and with an impaired renal function. There were no significant differences in the values of total cholesterol, LDL and apolipoprotein B. In women, triglyceride values are lower than men (133 mg / dl vs. 151 mg / dl), while those of HDL are generally higher (46 mg / dl vs. 39 mg / dl). In women, the levels of apoA1 are higher (125 mg / dl vs. 111 mg / dl) and consequently the ratio apolipoprotein B / apolipoprotein A1 (0.81 vs 0.97) appears to be lower. The plasma levels of Lp (a) were elevated in 37% of the total population and especially in women, in which the average concentration is about 40 mg / dl: the difference between the genders was not statistically significant. Conclusion: From our data it appears that the distribution of risk factors for ACS is dependent on sex and that, in light of the different post ACS prognosis, in certain subpopulations of patients, can be taken in consideration different treatment strategies.