Gender differences in elderly patients admitted to a coronary care unit

Type of funding sources: None.

Gender differences in cardiovascular diseases have been widely observed, and these affect both their management and prognosis.

This study aims to evaluate if such differences also exist in elderly patients who were admitted at our Coronary Care Unit (CCU).

Retrospective cohort of patients older than or equal to 80 years old who were admitted to a CCU in 2018-2019. We performed a descriptive analysis by gender, comparing comorbidities, causes of admission, complications, intrahospital mortality and after discharge, as well as readmissions.

148 patients ≥80 years old were admitted at our CCU. 50% were women, with similar median age (men 83.58± SD 3.65 years; women 84.45±SD 2.94) and Charlson index (6.08±SD 1.70; women 6.54±SD 1.78).

We observed a higher proportion of men with previous ischemic heart disease (46% vs. 22%, p=0.002). The rest of comorbidities were however similar, and hypertension and dyslipidemia were the most frequent ones. Concerning causes of admission at the CCU, Acute Coronary Syndrome (39% vs. 41% women) and Acute Heart Failure (18% vs. 23% women, p>0.05) were the most common.

Complications were also similar between both groups (acute kidney injury and heart failure were the most common). We didn’t observe either any differences in vasoactive drugs requeriments, need of ventilatory support and interventional procedure rates. Men had a higher proportion of severe left ventricular systolic dysfunction at discharge (41% vs. 13%, p<0.001), although there weren’t any differences in intrahospital mortality (22% vs. 28% in women, p>0.05).

During follow-up (median 41.57 weeks, IQR 20.71-63.86) there was a tendency towards higher mortality in men (25% compared to 13%, p=0.12). Readmissions however were similar in both groups (37% in men and 30% women, p>0.05).

We didn’t observe any significant gender differences concerning interventional procedures, complications and intrahospital mortality in patients ≥80 years old admitted at our CCU. Even though severe left ventricular systolic dysfunction at discharge was more common in men, mortality and readmissions were similar during follow-up.