Observational studyGlobal heart2015
Sex Differences in the Presentation, Diagnosis, and Management of Acute Coronary Syndromes: Findings From the Kerala-India ACS Registry.
Observational study in Global heart, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Gender differences in the management and outcomes of acute coronary syndrome in indians: A systematic review and meta-analysis.Indian heart journalPooled it
- Sex disparities in the presentation, management and outcomes of patients with acute coronary syndrome: insights from the ACS QUIK trial.Open heart · 2021Trial
- Forecasting Atherosclerotic Cardiovascular Disease in South Asia Until 2040: A Bayesian Modeling Approach.JACC. Asia · 2025Article
- Sex differences in atrial fibrillation in India: Insights from the Kerala-AF registry.Journal of arrhythmia · 2025Article
- Sex Differences in Acute Coronary Syndromes: A Global Perspective.Journal of cardiovascular development and disease · 2022Review
- Symptoms of Infarction in Women: Is There a Real Difference Compared to Men? A Systematic Review of the Literature with Meta-Analysis.Journal of clinical medicine · 2022Review
- Sex and Medium-term Outcomes of ST-Segment Elevation Myocardial Infarction in Kerala, India: A Propensity Score-Matched Analysis.CJC open · 2021Article
- Article
- Assessing cardiovascular disease risk factor screening inequalities in India using Lot Quality Assurance Sampling.BMC health services research · 2020Article
- India and the United Kingdom-What big data health research can do for a country.Learning health systems · 2019Article
- Health-Related Quality of Life at 30 Days Among Indian Patients With Acute Myocardial Infarction.Circulation. Cardiovascular quality and outcomes · 2019Article
- Overview of Coronary Heart Disease Risk Initiatives in South Asia.Current atherosclerosis reports · 2017Review
- Cardiological Society of India: Position statement for the management of ST elevation myocardial infarction in India.Indian heart journal · 2017Review
- Gender Bias in Cardiovascular Disease Prevention, Detection, and Management, with Specific Reference to Coronary Artery Disease.Journal of mid-life healthArticle
- Secondary prevention of cardiovascular diseases in India: Findings from registries and large cohorts.Indian heart journalReview
- Gender bias in acute myocardial infarction care in India: Nationwide retrospective study of 41832 patients.Indian heart journalObservational
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundPrevious literature from high-income countries has repeatedly shown sex differences in the presentation, diagnosis, and management of acute coronary syndromes (ACS), with women having atypical presentations and undergoing less aggressive diagnostic and therapeutic measures. However, much less data exist evaluating sex differences in ACS in India.
objectivesThis study sought to evaluate sex differences in the diagnosis, management, and treatment of patients with ACS in Kerala, India.
methodsThe Kerala ACS Registry collected data from 25,748 consecutive ACS admissions (19,923 men and 5,825 women) from 125 hospitals in the Indian state of Kerala from 2007 to 2009. This study evaluated the association between sex differences in presentation, in-hospital management, and discharge care with in-hospital mortality and in-hospital major adverse cardiovascular events (defined as death, reinfarction, stroke, heart failure, or cardiogenic shock).
resultsWomen with ACS were older than men with ACS (64 vs. 59, p < 0.001) and were more likely to have a history of previous myocardial infarction (16% vs. 14%, p < 0.001). Inpatient diagnostics and management and discharge care were similar between sexes. No significant differences between men and women in the outcome of death (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 0.80 to 1.38) or in the composite outcome of death, reinfarction, stroke, heart failure, or cardiogenic shock (OR: 0.99, 95% CI: 0.79 to 1.25) were seen after adjustment for possible confounding factors.
conclusionsIn Kerala, even though women with ACS were older and more likely to have previous myocardial infarction, there were no significant differences in in-hospital and discharge management, in-hospital mortality, or major adverse cardiovascular events between sexes. Whether these results apply to other parts of India or acute presentations of other chronic diseases in low- and middle-income countries warrants further study.
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