Sex Versus Gender-Related Characteristics Which Predicts Outcome after Acute Coronary Syndrome in the Young?

Roxanne Pelletier; Nadia A. Khan; Jafna Cox; Stella S. Daskalopoulou; Mark J. Eisenberg; Simon L. Bacon; Kim L. Lavoie; Kaberi Daskupta; Doreen Rabi; Karin H. Humphries; Colleen M. Norris; George Thanassoulis; Hassan Behlouli; Louise Pilote

doi:10.1016/j.jacc.2015.10.067

Sex Versus Gender-Related Characteristics Which Predicts Outcome after Acute Coronary Syndrome in the Young?

Roxanne Pelletier, Nadia A. Khan, Jafna Cox, Stella S. Daskalopoulou, Mark J. Eisenberg, Simon L. Bacon, Kim L. Lavoie, Kaberi Daskupta, Doreen Rabi, Karin H. Humphries, Colleen M. Norris, George Thanassoulis, Hassan Behlouli, Louise Pilote

Résultat de recherche: Article › examen par les pairs

242 Citations (Scopus)

Résumé

Background "Gender" reflects social norms for women and men, whereas "sex" defines biological characteristics. Gender-related characteristics explain some differences in access to care for premature acute coronary syndrome (ACS); whether they are associated with cardiovascular outcomes is unknown. Objectives This study estimated associations between gender and sex with recurrent ACS and major adverse cardiac events (MACE) (e.g., ACS, cardiac mortality, revascularization) over 12 months in patients with ACS. Methods We studied 273 women and 636 men age 18 to 55 years from GENESIS-PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond-Premature Acute Coronary SYndrome), a prospective observational cohort study, who were hospitalized for ACS between January 2009 and April 2013. Gender-related characteristics (e.g., social roles) were assessed using a self-administered questionnaire, and a composite measure of gender was derived. Outcomes included recurrent ACS and MACE over 12 months. Results Feminine roles and personality traits were associated with higher rates of recurrent ACS and MACE compared with masculine characteristics. This difference persisted for recurrent ACS, after multivariable adjustment (hazard ratio from score 0 to 100: 4.50; 95% confidence interval: 1.05 to 19.27), and was a nonstatistically significant trend for MACE (hazard ratio: 1.54; 95% confidence interval: 0.90 to 2.66). A possible explanation is increased anxiety, the only condition that was more prevalent in patients with feminine characteristics and that rendered the association between gender and recurrent ACS nonstatistically significant (hazard ratio: 3.56; 95% confidence interval: 0.81 to 15.61). Female sex was not associated with outcomes post-ACS. Conclusions Younger adults with ACS with feminine gender are at an increased risk of recurrent ACS over 12 months, independent of female sex.

Langue d'origine	English
Pages (de-à)	127-135
Nombre de pages	9
Journal	Journal of the American College of Cardiology
Volume	67
Numéro de publication	2
DOI	https://doi.org/10.1016/j.jacc.2015.10.067
Statut de publication	Published - janv. 19 2016
Publié à l'externe	Oui

Note bibliographique

Funding Information:
This study was funded by the Heart and Stroke Foundations of Quebec, Nova Scotia, Alberta, Ontario, Yukon, and British Columbia, Canada, and the Canadian Institutes of Health Research (CIHR). The study sponsors had no role in the design of the study; the collection, analysis, or interpretation of data; the preparation of the report; review; or approval of the manuscript. Dr. Pelletier is supported by a CIHR award. Dr. Khan is supported by a Michael Smith Foundation for Health Research Career Scientist award. Dr. Daskalopoulou is Chercheur-Boursier Clinicien, supported by a Fonds de Recherche du Quebec–Sante (FRQS) salary award. Dr. Bacon is supported by an FRQS salary award; has received investigator initiated grant funding from GlaxoSmithKline and Abbvie; has received personal fees from Kataka Medical Communication; and has received speaker fees from Novartis. Dr. Lavoie is supported by CIHR New Investigator and FRQS salary awards; and has received consultancy and/or presentation fees from Takeda, AbbVie, Boehringer Ingelheim, Janssen, Bayer, Mundi Pharma, AstraZeneca, and Merck. Dr. Daskupta holds a Senior Clinician Scientist salary award from the FRQS. Dr. Thanassoulis is on the speakers bureau of Servier Canada; and has received a grant from ISIS pharmaceuticals. Dr. Pilote holds a James McGill Chair in medicine. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Publisher Copyright:
© 2016 American College of Cardiology Foundation.

ASJC Scopus Subject Areas

Cardiology and Cardiovascular Medicine

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

ODD de l’ONU

Cette action contribue à la réalisation des objectifs de développement durable suivants

Accès au document

10.1016/j.jacc.2015.10.067

Autres fichiers et liens

Citer

Pelletier, R., Khan, N. A., Cox, J., Daskalopoulou, S. S., Eisenberg, M. J., Bacon, S. L., Lavoie, K. L., Daskupta, K., Rabi, D., Humphries, K. H., Norris, C. M., Thanassoulis, G., Behlouli, H., & Pilote, L. (2016). Sex Versus Gender-Related Characteristics Which Predicts Outcome after Acute Coronary Syndrome in the Young? Journal of the American College of Cardiology, 67(2), 127-135. https://doi.org/10.1016/j.jacc.2015.10.067

Pelletier, R, Khan, NA, Cox, J, Daskalopoulou, SS, Eisenberg, MJ, Bacon, SL, Lavoie, KL, Daskupta, K, Rabi, D, Humphries, KH, Norris, CM, Thanassoulis, G, Behlouli, H & Pilote, L 2016, 'Sex Versus Gender-Related Characteristics Which Predicts Outcome after Acute Coronary Syndrome in the Young?', Journal of the American College of Cardiology, vol. 67, n° 2, pp. 127-135. https://doi.org/10.1016/j.jacc.2015.10.067

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title = "Sex Versus Gender-Related Characteristics Which Predicts Outcome after Acute Coronary Syndrome in the Young?",

abstract = "Background {"}Gender{"} reflects social norms for women and men, whereas {"}sex{"} defines biological characteristics. Gender-related characteristics explain some differences in access to care for premature acute coronary syndrome (ACS); whether they are associated with cardiovascular outcomes is unknown. Objectives This study estimated associations between gender and sex with recurrent ACS and major adverse cardiac events (MACE) (e.g., ACS, cardiac mortality, revascularization) over 12 months in patients with ACS. Methods We studied 273 women and 636 men age 18 to 55 years from GENESIS-PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond-Premature Acute Coronary SYndrome), a prospective observational cohort study, who were hospitalized for ACS between January 2009 and April 2013. Gender-related characteristics (e.g., social roles) were assessed using a self-administered questionnaire, and a composite measure of gender was derived. Outcomes included recurrent ACS and MACE over 12 months. Results Feminine roles and personality traits were associated with higher rates of recurrent ACS and MACE compared with masculine characteristics. This difference persisted for recurrent ACS, after multivariable adjustment (hazard ratio from score 0 to 100: 4.50; 95% confidence interval: 1.05 to 19.27), and was a nonstatistically significant trend for MACE (hazard ratio: 1.54; 95% confidence interval: 0.90 to 2.66). A possible explanation is increased anxiety, the only condition that was more prevalent in patients with feminine characteristics and that rendered the association between gender and recurrent ACS nonstatistically significant (hazard ratio: 3.56; 95% confidence interval: 0.81 to 15.61). Female sex was not associated with outcomes post-ACS. Conclusions Younger adults with ACS with feminine gender are at an increased risk of recurrent ACS over 12 months, independent of female sex.",

author = "Roxanne Pelletier and Khan, {Nadia A.} and Jafna Cox and Daskalopoulou, {Stella S.} and Eisenberg, {Mark J.} and Bacon, {Simon L.} and Lavoie, {Kim L.} and Kaberi Daskupta and Doreen Rabi and Humphries, {Karin H.} and Norris, {Colleen M.} and George Thanassoulis and Hassan Behlouli and Louise Pilote",

note = "Funding Information: This study was funded by the Heart and Stroke Foundations of Quebec, Nova Scotia, Alberta, Ontario, Yukon, and British Columbia, Canada, and the Canadian Institutes of Health Research (CIHR). The study sponsors had no role in the design of the study; the collection, analysis, or interpretation of data; the preparation of the report; review; or approval of the manuscript. Dr. Pelletier is supported by a CIHR award. Dr. Khan is supported by a Michael Smith Foundation for Health Research Career Scientist award. Dr. Daskalopoulou is Chercheur-Boursier Clinicien, supported by a Fonds de Recherche du Quebec–Sante (FRQS) salary award. Dr. Bacon is supported by an FRQS salary award; has received investigator initiated grant funding from GlaxoSmithKline and Abbvie; has received personal fees from Kataka Medical Communication; and has received speaker fees from Novartis. Dr. Lavoie is supported by CIHR New Investigator and FRQS salary awards; and has received consultancy and/or presentation fees from Takeda, AbbVie, Boehringer Ingelheim, Janssen, Bayer, Mundi Pharma, AstraZeneca, and Merck. Dr. Daskupta holds a Senior Clinician Scientist salary award from the FRQS. Dr. Thanassoulis is on the speakers bureau of Servier Canada; and has received a grant from ISIS pharmaceuticals. Dr. Pilote holds a James McGill Chair in medicine. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: {\textcopyright} 2016 American College of Cardiology Foundation.",

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doi = "10.1016/j.jacc.2015.10.067",

language = "English",

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journal = "Journal of the American College of Cardiology",

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