SO SÁNH TỶ LỆ KẾT CỤC NỘI VIỆN VÀ CÁC YẾU TỐ DỰ ĐOÁN Ở BỆNH NHÂN NAM VÀ NỮ MẮC HỘI CHỨNG VÀNH CẤP

Abstract

Background: Women’s distinct physiological and anatomical features are linked to a rising burden of cardiovascular disease. Compared with men, women with acute coronary syndromes more often have multiple comorbidities, present with atypical symptoms, and tend to arrive later to hospital. Evidence directly comparing clinical and subclinical characteristics by sex, identifying associated factors, and determining sex-specific predictors of in-hospital outcomes remains limited. Objectives: To compare clinical and subclinical features, in-hospital outcomes, and predictors of in-hospital outcomes between men and women with acute coronary syndrome (ACS). Methods: We conducted a prospective and retrospective cohort study of 213 ACS patients admitted to and treated in the Interventional Cardiology Department of Gia Dinh People’s Hospital from March to September 2025 who met inclusion and exclusion criteria. Results: Mean age was 63.14 ± 12.3 years; 65.7% were men. Dyslipidemia and hypertension were the most common comorbidities. Time from symptom onset to admission was shorter in men (9 hours) than in women (17 hours). Clopidogrel predominated in women (82.2%), while in men ticagrelor (53.6%) was used at a rate similar to clopidogrel (55.7%). Major adverse cardiovascular events occurred in 23% of patients. Mortality, acute heart failure, and cardiogenic shock were all higher in women. In multivariable analysis, predictors of in-hospital outcomes in men were systolic blood pressure, ejection fraction, and loop-diuretic use; in women, independent predictors were a history of diabetes mellitus and admission heart rate. Conclusion: Women received less aggressive invasive strategies, reflected by lower rates of coronary angiography and revascularization. In men, predictors emphasize control of clinical severity, whereas in women, comorbid conditions—particularly diabetes mellitus—play a decisive role.