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Sex differences in long-term outcomes in older adults undergoing invasive treatment for non-ST elevation acute coronary syndrome: An ICON-1 sub-study

Lookup NU author(s): Dr Hanna Ratcovich, Dr Mohammad Alkhalil, Dr Ben Beska, Dr Mike Lawless, Dr Chris WilkinsonORCiD, Professor Vijay KunadianORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© 2022 The AuthorsBackground: Cardiovascular disease is the leading cause of mortality for females globally, yet females are underrepresented in studies of acute coronary syndrome (ACS). Studies investigating sex-related differences in clinical outcomes of patients with non-ST elevation ACS (NSTEACS) have reported divergent results, and it is unknown whether long-term outcomes for older people with NSTEACS differ between males and females. Methods: The multi-centre prospective cohort study, ICON-1, consisted of patients aged ≥75 years undergoing coronary angiography following NSTEACS. The primary composite endpoint was all-cause mortality, myocardial infarction, unplanned revascularisation, stroke, and bleeding. We report outcomes at five-years by sex. Results: Of 264 patients, 102 (38.6%) females and 162 (61.4%) males completed the five-year follow-up and were included in the analytic cohort. At admission, females were older than males (82 ± 4.3 years vs 80.0 ± 4.1 years p = 0.018). Co-morbidity profile and GRACE score were similar between the groups. There were no differences in the provision of invasive or pharmacological treatments between sexes. At five-years, there were no association between sex and the primary outcome. Conclusion: In older adults with invasive treatment of NSTEACS, provision of guideline-indicated care and long-term clinical outcomes were similar between males and females.

Publication metadata

Author(s): Ratcovich H, Alkhalil M, Beska B, Holmvang L, Lawless M, Gede Dennis Sukadana I, Wilkinson C, Kunadian V

Publication type: Article

Publication status: Published

Journal: IJC Heart and Vasculature

Year: 2022

Volume: 42

Print publication date: 01/10/2022

Online publication date: 06/09/2022

Acceptance date: 31/08/2022

Date deposited: 19/06/2023

ISSN (electronic): 2352-9067

Publisher: Elsevier Ireland Ltd


DOI: 10.1016/j.ijcha.2022.101118


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