• Antonio Martínez-Guisado, Pedro Cepas-Guillén, Pablo Díez-Villanueva, María Thiscal López Lluva, Alfonso Jurado-Román, Pablo Bazal-Chacón, Martín Negreira-Caamaño, Iván Olavarri-Miguel, Ane Elorriaga, Ricardo Rivera-López, David Escribano, Pablo Salinas, Jessica Vaquero-Luna, Alicia Prieto, Lucía Pérez-Cebey, Anna Carrasquer, Isaac Llaó, Fernando José Torres Mezcúa, Teresa Giralt-Borrell, Lucía Matute-Blanco, Clara Fernández-Cordón, Clea González, Emilio Arbas-Redondo, David Aritza-Conty, and Felipe Díez-Delhoyo.
• Servicio de Cardiología, Hospital Clinic, Barcelona, España.
• Emergencias. 2024 Apr 1; 36 (2): 123130123-130.

ObjectivesTo assess differences in the clinical management of nonST-segment elevation myocardial infarction (NSTEMI), including in-hospital events, according to biological sex.Material And MethodsProspective observational multicenter study of patients diagnosed with NSTEMI and atherosclerosis who underwent coronary angiography.ResultsWe enrolled 1020 patients in April and May 2022; 240 (23.5%) were women. Women were older than men on average (72.6 vs 66.5 years, P .001), and more women were frail (17.1% vs 5.6%, P .001). No difference was observed in pretreatment with any P2Y12 inhibitor (prescribed in 68.8% of women vs 70.2% of men, P = .67); however, more women than men were prescribed clopidogrel (56% vs 44%, P = .009). Women prescribed clopidogrel were more often under the age of 75 years and not frail. Coronary angiography was performed within 24 hours less corooften in women (29.8% vs 36.9%, P = .03) even when high risk was recognized. Frailty was independently associated with deferring coronary angiography in the adjusted analysis; biological sex by itself was not related. The frequency and type of revascularization were the same in both sexes, and there were no differences in in-hospital cardiovascular events.ConclusionWomen were more often prescribed less potent antithrombotic therapy than men. Frailty, but not sex, correlated independently with deferral of coronary angiography. However, we detected no differences in the frequency of coronary revascularization or in-hospital events according to sex.

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