Sex Differences in In-hospital Management and Outcomes of Patients with Acute Coronary Syndrome: Findings from the Improving Care for Cardiovascular Disease in China (CCC) Project

Background: Coronary heart disease (CHD) is a leading cause of mortality among women. Systematic evaluation of the quality of care and outcomes in women hospitalized for acute coronary syndrome (ACS), an acute manifestation of CHD, remains lacking in China. Methods: The Improving Care for Cardiovascular Disease in China (CCC)-ACS project is an ongoing nationwide registry of the American Heart Association and Chinese Society of Cardiology. Using data from the CCC-ACS project, we evaluated sex differences in acute management, medical therapies for secondary prevention, and in-hospital mortality in 82 196 patients admitted for ACS at 192 hospitals in China from 2014 to 2018. Results: Women with ACS were older than men (69.0 vs. 61.1 years, P<0.001) and had more comorbidities. After multivariable adjustment, eligible women were less likely to receive evidence-based acute treatments for ACS than men, including early dual antiplatelet therapy (DAPT), heparins during hospitalization, and reperfusion therapy for ...