Sex Characteristics – ABC CARDIOL

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Letter to the Editor

Use of Atherogenic Indices as Assessment Methods of Clinical Atherosclerotic Diseases

To the Editor,

The recent publication by Araujo et al. provides valuable insight into the relationship between atherosclerosis and the atherogenic index of plasma (AIP), Castelli Risk Index I (CRI-I), and Castelli Risk Index II (CRI-II). Their results, showing elevated index values in patients with atherosclerotic disease compared with controls, underscore the potential role of these lipid-derived ratios as practical and inexpensive predictors of cardiovascular risk within a Brazilian population.

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Original Article

Sex Differences in Outcomes of ST Elevation Myocardial Infarction Patients Submitted to Primary Percutaneous Coronary Intervention

Victoria B. Milan et al. Yasmin F. S. Alves Guilherme P. Machado Gustavo Neves de Araujo … Ana Maria Krepsky Angelo Chies Matheus Niches Julia Fracasso Sandro Cadaval Goncalves Marco Wainstein Carisi Anne Polanczyk

Abstract

Background

Several studies have shown that women are usually undertreated and have worse outcomes after ST-segment elevation myocardial infarction (STEMI), hence the need to investigate questions related to sex in Brazil to better deal with the problem.

Objective

To determine whether female sex is still associated with adverse events in a contemporary cohort of patients with STEMI undergoing primary percutaneous coronary intervention (pPCI).

Methods

This was a prospective cohort study of STEMI patients submitted to pPCI in a tertiary university hospital between March 2011 and December 2021. Patients were categorized into groups based on their sex at birth. The primary clinical outcome was long-term MACCE. Patients were followed-up for up to five years. All hypothesis tests had a two-sided significance level of 0.05.

Results

Among 1457 patients admitted with STEMI in the study period, 1362 were included and 468 (34.4%) were women. Female patients had a higher prevalence of hypertension (73% vs. 60%, p <0.001), diabetes (32% vs. 25%, p=0.003) and Killip class 3-4 at hospital admission (17% vs. 12%, p=0.01); TIMI risk score was higher among women (4 [2, 6] vs. 3 [2, 5], p<0.001). In-hospital mortality was not different between groups (12.8% vs. 10.5%, p=0.20). In-hospital MACCE (16.0% vs. 12.6%, p=0.085) and long-term MACCE (28.7% vs. 24.4%, p=0.089) were numerically higher in women, with borderline significance. After multivariate analysis, female sex was not associated with MACCE (HR = 1.14; 95% CI 0.86 – 1.51; p = 0.36).

Conclusion

In a prospective cohort of STEMI patients submitted to pPCI, female patients were older and had more comorbidities at baseline, but no significant differences were found in terms of long-term adverse outcomes.

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Original Article

Sex Differences in High Sensitivity C-Reactive Protein in Subjects with Risk Factors of Metabolic Syndrome

Vinicius Pacheco Garcia et al. Helena Naly Miguens Rocha Allan Robson Kluser Sales Natália Galito Rocha Antonio Claudio Lucas da Nóbrega

Abstract

Background:

Metabolic syndrome (MetS) is associated with a higher risk of all-cause mortality. High-sensitivity C-reactive protein (hsCRP) is a prototypic marker of inflammation usually increased in MetS. Women with MetS-related diseases present higher hsCRP levels than men with MetS-related diseases, suggesting sex differences in inflammatory markers. However, it is unclear whether serum hsCRP levels are already increased in men and/or women with MetS risk factors and without overt diseases or under pharmacological treatment.

Objective:

To determine the impact of the number of MetS risk factors on serum hsCRP levels in women and men.

Methods

One hundred and eighteen subjects (70 men and 48 women; 36 ± 1 years) were divided into four groups according to the number of MetS risk factors: healthy group (CT; no risk factors), MetS ≤ 2, MetS = 3, and MetS ≥ 4. Blood was drawn after 12 hours of fasting for measurement of biochemical variables and hsCRP levels, which were determined by immunoturbidimetric assay.

Results:

The groups with MetS risk factors presented higher serum hsCRP levels when compared with the CT group (p 0.05). The best linear regression model to explain the association between MetS risk factors and hsCRP levels included waist circumference and HDL cholesterol (r = 0.40, p < 0.01). Women with MetS risk factors presented higher hsCRP levels when compared with men (p_sex < 0.01).

Conclusions:

Despite the absence of overt diseases and pharmacological treatment, subjects with MetS risk factors already presented increased hsCRP levels, which were significantly higher in women than men at similar conditions.

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Use of Atherogenic Indices as Assessment Methods of Clinical Atherosclerotic Diseases

Sex Differences in Outcomes of ST Elevation Myocardial Infarction Patients Submitted to Primary Percutaneous Coronary Intervention

Abstract

Background

Objective

Methods

Results

Conclusion

Sex Differences in High Sensitivity C-Reactive Protein in Subjects with Risk Factors of Metabolic Syndrome

Abstract

Background:

Objective:

Methods

Results:

Conclusions:

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