Sex differences in epidemiology and risk factors of acute coronary syndrome in Chinese patients with type 2 diabetes: A long-term prospective cohort study

J.G. Duan, Xiangyan Chen, L. Wang, A. Lau, A. Wong, G.N. Thomas, B. Tomlinson, R. Liu, J.C.N. Chan, T.W. Leung, V. Mok, K.S. Wong

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14 Citations (Scopus)


Copyright: © 2015 Duan et al.Objective: Diabetic patients with acute coronary syndrome (ACS) are at higher risk of poor outcome than are non-diabetic patients with ACS. Few studies have focused on sex-related ACS incidence, ACS-related mortality or risk factors to affects sex specific ACS in Chinese with Type 2 diabetes mellitus (T2DM). Based on a hospital-based cohort of Chinese patients with T2DM, we aimed to investigate whether there was sex difference in ACS or ACSrelated mortality or risk factors of ACS. Methods: Totally 2,135 Hong Kong Chinese with T2DM were recruited during 1994-1996 and followed up until August 2012. We systematically analyzed sex-related ACS incidence and ACSrelated mortality and risk factors with ?<sup>2</sup>-squared test, descriptive statistics and survival analysis. Results: Regular follow-up was completed in 2,105 subjects (98.6%), with a median period of 14.53 years. The occurrence of ACS was recorded among 414 patients (19.7%) and ACS-related death among 104 patients (4.9%). ACS incidences increased with age in both men and women, and men had a higher prevalence of ACS than women across different age categories and different follow-up periods (log rank ?<sup>2</sup>=20.32, P<0.001). The transition of ACS incidences from slow to rapid increase were about 5 years earlier in men (at 51-55 years) than in women (55-60 years). Among ACS patients, cumulative ACS-related mortalities was similar between men and women (log rank ?<sup>2</sup>=0.063, P=0.802). Besides age and albuminuria, different profiles of risk factors accounted for the occurrence of ACS between men and women. Conclusions: Our findings demonstrated sex differences in ACS incidence and risk factors, but not in ACS-related mortality in Chinese patients withT2DM. These findings suggest that screening and prevention campaigns should be optimized for men and women, which may help to identify diabetic patients at higher risk of coronary heart disease.
Original languageEnglish
Article numbere0122031
JournalPLoS ONE
Issue number4
Publication statusPublished - 1 Apr 2015
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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