The following is a summary of “Sex differences in survival following acute coronary syndrome with and without standard modifiable risk factors,” published in the November 2024 issue of Cardiology by Anand et al.  

Cardiovascular disease (CVD) is a leading cause of death globally, with acute coronary syndrome (ACS) significantly affecting mortality rates among both sexes. Understanding the impact of standard modifiable risk factors (SMuRFs) on outcomes is crucial for improving patient care.  

Researchers conducted a retrospective study to examine sex differences in mortality risk between patients with ACS without SMuRF-less and those with at least 1 SMuRF.  

They searched MEDLINE and Embase databases reporting sex-stratified outcomes for SMuRF-less vs. SMuRF patients with ACS (December 15, 2023). Categorical variables were analyzed using a generalized linear mixed model, while continuous variables were evaluated through a meta-analysis of means with an inverse variance method.  

The results showed that excess in-hospital mortality was found in SMuRF-less female patients with ACS compared to those with SMuRFs (risk ratio [RR] 1.56, 95% CI 1.08–2.25, P=0.029), while no difference was noted in males (RR 1.59, 95% CI 0.90–2.80, P=0.088). Over more extended follow-up periods, 1- and 2-year post-ACS mortality rates were similar between the SMuRF-less and SMuRF for both genders. Subgroup analysis revealed that SMuRF-less females experienced higher in-hospital (RR 1.52, 95% CI 1.30–1.78, P=0.002), 1-year (RR 1.51, 95% CI 1.34–1.71, P=0.005), and 2-year mortality risks (RR 1.40, 95% CI 1.13–1.75, P=0.016) compared to males.  

They concluded that females without CV risk factors were at a disproportionately higher risk for short- and medium-term mortality following ACS compared to their male counterparts.  

Source: link.springer.com/article/10.1007/s00392-024-02563-7