Mucio Tavares de Oliveira Junior

Por que os portadores de cardiomiopatia chagásica têm pior evolução que os não-chagásicos?

BACKGROUND: Heart failure is a highly prevalent disease, the prognosis of which depends on different predictive factors. OBJECTIVE: Chagas disease is a predictor of poor prognosis in patients with chronic heart failure (HF). The purpose of this study is to investigate whether this condition also predicts poor outcome in acutely decompensated patients. METHODS: Four hundred and seventeen patients admitted for decompensated heart failure were studied. Mean age was 51.8 years, and 291 (69.8%) were male. They were divided into two groups: 133 (31.9%) patients with Chagas heart disease (CH) and 284 patients with heart failure of other etiologies. Cytokine and norepinephrine plasma levels were measured in a subgroup of 63 patients (15.1% with Chagas disease). RESULTS: At admission, 24.6% of the patients needed inotropic support, and one-year mortality was 54.7%. Mortality rates were higher in the CH group (69.2% vs. 47.9%, p < 0.001). When data were compared, patients with Chagas disease were younger (47.6 vs. 53.8 years, p < 0.001) and, on average, showed lower systolic blood pressure (96.7 vs. 111.2 mmHg, p < 0,001), ejection fraction (32.7 vs. 36.4%, p < 0.001), and serum Na (134.6 vs. 136.0, p = 0.026), in addition to higher TNF-α levels (33.3 vs. 14.8, p = 0.001). The presence of hypotension requiring inotropic support, left ventricular (LV) diastolic diameter, renal function findings, and interleukin-6 and norepinephrine plasma levels did not differ between both groups. CONCLUSION: Chagas disease patients admitted with decompensated heart failure had worse prognoses than patients with heart failure of other etiologies. This may be owing to a greater degree of cardiac impairment (lower ejection fraction) and hemodynamic instability (lower systolic blood pressure and heart rate), increased activation of the renin-angiotensin system (lower sodium), and increased cytokine levels (TNF-α).

Repercussão Nutricional na Insuficiência Cardíaca Avançada e seu Valor na Avaliação Prognóstica Nutritional Repercussion in Advanced Heart Failure and its Value in Prognostic Assessment

OBJECTIVE To analyze the nutritional repercussion in heart failure and its relations with left ventricular dysfunction and mortality. METHODS A series of nutritional parameters in a group of 95 patients with advanced chronic heart failure, arising out of dilated cardiomyopathy and age < 65 years old, without concomitant diseases was studied. The duration of symptons, final diastolic diameter and left ventricular ejection fraction were verified. The nutritional assessment, included the ideal percentage of weight the triceps skin fold thickness, percentiles of circumference of muscular mass of the arm, the albumin serum levels and the lymphocytes global count. RESULTS The nutritional situation was alterated in 45.3% to 94.7% of the patients in accordance to the assessment parameter used. There was neither correlation between the nutritional parameters and the length of symptoms, nor with the ventricular dysfunction level. That group of patients had a homogenous evolution, and 75.8% of them died in an average time of 21.86 weeks. The left ventricular diastolic diameter and ejection fraction did not allow for the prediction of survival. A diminished body mass identified a group with higher risk of death. The ideal percentage of the body mass was predictive of survival (p=0.0352), the patients with less than 80% of ideal weight had a higher relative risk of death of 1.99 (1.12-3.02) (p=0.0132). CONCLUSION Malnutrition is frequent in patients with advanced heart failure and dilated cardiomyopathy. The reduced body mass was a better predictor of survival than the left ventricular ejection fraction in patients under advanced stage of myocardial compromising.OBJETIVO: Analisar a repercussao nutricional na insuficiencia cardiaca e suas relacoes com a disfuncao ventricular esquerda e a mortalidade. METODOS: Estudou-se uma serie de parâmetros nutricionais num grupo de 95 pacientes com insuficiencia cardiaca cronica avancada decorrente de cardiomiopatia dilatada e idade < 65 anos, sem evidencias de doencas concomitantes. Foram verificados a duracao dos sintomas, o diâmetro diastolico final e a fracao de ejecao do ventriculo esquerdo. A avaliacao nutricional incluiu a percentagem ideal do peso, a espessura da prega tricipital, os percentis da circunferencia da massa muscular do braco, os niveis sericos de albumina e a contagem global dos linfocitos. RESULTADOS: A situacao nutricional esteve alterada em 45,3% a 94,7% dos pacientes conforme o parâmetro da avaliacao empregado. Nao houve correlacao entre os parâmetros nutricionais e a duracao dos sintomas, nem com o grau de disfuncao ventricular. Este grupo de pacientes teve uma evolucao homogenea e 75,8% dos pacientes faleceram num tempo medio de 21,86 semanas. O diâmetro diastolico e a fracao de ejecao do ventriculo esquerdo nao permitiram predizer a sobrevida. Uma massa corporea diminuida identificou um grupo com maior risco de morte. A percentagem ideal do peso corporeo foi preditiva da sobrevida (p=0,0352), os pacientes com menos de 80% do peso ideal tiveram um risco relativo maior de morte de 1,99 (1,12-3,02) (p=0,0132). CONCLUSAO: A desnutricao e frequente nos pacientes com insuficiencia cardiaca avancada e cardiomiopatia dilatada. A massa corporea reduzida foi melhor preditor de sobrevida do que a fracao de ejecao do ventriculo esquerdo, nos pacientes em fase avancada de comprometimento miocardico.

Escore para avaliação do estado nutricional: seu valor na estratificação prognóstica de portadores de cardiomiopatia dilatada e insuficiência cardíaca avançada

OBJECTIVE Develop a method for the evaluation of patients nutritional status through a score that expresses universal nutritional status, as well as investigate if that score would be efficient for the prognostic stratification of advanced heart failure (HF) pts. METHODS The score was reached by the selection of evaluation methods that would quantify nutritional status: ideal body weight percentage, thickness of tricipital skinfold, percentiles for arm muscular mass circumference, albumin serum level, lymphocyte total count. In order to be validated, the score was applied to a group of 95 pts. Pts were under 65 years old no evidence of consumptive diseases. The score was analyzed to confirm whether it would keep correlation with HF clinical data and whether it would stratify its prognostic. RESULTS Nutritional status suggesting moderate or severe malnutrition could be observed in 31/95 (32.6%). No correlation was found between nutritional score values and the duration of symptoms, or the level of ventricular dysfunction. Pts with high nutritional score showed a trend towards higher mortality rate (p=0.0606). CONCLUSION Those data suggest malnutrition is reported by 1/3 of pts with advanced HF. A score comprising 5 parameters for nutritional status showed good correlation with the clinical, global evaluation of pts with HF. A score over 8 identified pts with higher probability of death as outcome, confirming that pts under higher malnutrition exhibit worse evolution.OBJETIVO: Desenvolver metodo de avaliacao do estado nutricional do paciente atraves de escore que expresse o estado nutricional de maneira universal e verificar se esse escore seria eficaz na estratificacao prognostica de pacientes com insuficiencia cardiaca (IC) avancada. METODOS: Para compor o escore foram selecionados metodos de avaliacao que procurassem quantificar forma de medida do estado nutricional: a porcentagem ideal do peso, a espessura da prega tricipital, os percentis da circunferencia da massa muscular do braco, os niveis sericos de albumina, a contagem global de linfocitos. Para valida-lo, aplicou-se o escore num grupo de 95 pacientes com idade inferior a 65 anos, sem evidencias de doencas consumptivas e analisou-se se esse escore manteria correlacao com os dados clinicos da IC e permitiria estratificar o prognostico. RESULTADOS: A situacao nutricional esteve alterada nos pacientes e escore elevado sugerindo desnutricao moderada ou intensa foi observado em 31/95 (32,6%) dos casos. Nao houve correlacao entre os valores do escore nutricional, duracao dos sintomas e grau de disfuncao ventricular. Os pacientes com escore nutricional elevado apresentaram tendencia de maior mortalidade (p=0,0606). CONCLUSOES: Os dados sugerem que a desnutricao atinge cerca de 1/3 dos pacientes com IC avancada. Um escore que englobou cinco parâmetros de avaliacao nutricional teve boa correlacao com a avaliacao clinica e permitiu avaliar globalmente a desnutricao de portadores de IC. Escore superior a 8 identificou pacientes com maior probabilidade de morrer, confirmando que pacientes mais desnutridos tem pior evolucao.

Cardiac troponin T for risk stratification in decompensated chronic heart failure

FUNDAMENTO: As troponinas cardiacas sao marcadores altamente sensiveis e especificos de lesao miocardica. Esses marcadores foram detectados na insuficiencia cardiaca (IC) e estao associadas com mau prognostico. OBJETIVO: Avaliar a relacao da troponina T (cTnT) e suas faixas de valores com o prognostico na IC descompensada. METODOS: Estudaram-se 70 pacientes com piora da IC cronica que necessitaram de hospitalizacao. Na admissao, o modelo de Cox foi utilizado para avaliar as variaveis capazes de predizer o desfecho composto por morte ou re-hospitalizacao em razao de piora da IC durante um ano. RESULTADOS: Durante o seguimento, ocorreram 44 mortes, 36 re-hospitalizacoes por IC e 56 desfechos compostos. Na analise multivariada, os preditores de eventos clinicos foram: cTnT (cTnT > 0,100 ng/ml; hazard ratio (HR) 3,95 intervalo de confianca (IC) 95%: 1,64-9,49, p = 0,002), diâmetro diastolico final do ventriculo esquerdo (DDVE >70 mm; HR 1,92, IC95%: 1,06-3,47, p = 0,031) e sodio serico (Na 0,020 e 0,100 ng/ml, n = 12). As probabilidades de sobrevida e sobrevida livre de eventos foram: 54,2%, 31,5%, 16,7% (p = 0,020), e 36,4%, 11,5%, 8,3% (p = 0,005), respectivamente. CONCLUSAO: A elevacao da cTnT esta associada com mau prognostico na IC descompensada, e o grau dessa elevacao pode facilitar a estratificacao de risco.BACKGROUND The cardiac troponins are highly sensitive and specific markers of myocardial injury. They have been detected in heart failure (HF) and are associated with a bad prognosis. OBJECTIVE To evaluate the association of cardiac troponin T (cTnT) and its ranges with prognosis in decompensated HF. METHODS A total of 70 patients with chronic HF worsening that needed hospitalization were studied. Cox model was used to evaluate the variables at admission capable of predicting the combined outcome that consisted of death or re-hospitalization due to HF worsening during a 1-year follow-up. RESULTS During the follow-up, there were 44 deaths, 36 re-hospitalizations due to HF and 56 combined outcomes. At the multivariate analysis, the predictors of clinical events were the cTnT (cTnT > or = 0.100 ng/mL; hazard ratio [HR] 3.95 95% confidence interval [CI]: 1.64-9.49, p = 0.002), left ventricular end diastolic diameter (LVDD > or = 70 mm; HR 1.92, 95%CI: 1.06-3.47, p = 0.031) and serum sodium (Na < 135 mEq/L; HR 1.79, 95%CI: 1.02-3.15, p = 0.044). To evaluate the association between the cTnT increase and the prognosis in decompensated HF, the patients were stratified in three groups: low-cTnT (cTnT <0.020 ng/ml, n = 22), intermediate-cTnT (cTnT > 0.020 and < 0.100 ng/ml, n = 36), and high-cTnT (cTnT > or = 0.100 ng/ml, n = 12).The probabilities of survival and event-free survival were 54.2%, 31.5%, 16.7% (p = 0.020) and 36.4%, 11.5%, 8.3% (p = 0.005), respectively. CONCLUSION The increase in cTnT is associated with a bad prognosis in decompensated HF and the degree of this increase can help the risk stratification.

Troponina cardíaca T para estratificação de risco na insuficiência cardíaca crônica descompensada

FUNDAMENTO: As troponinas cardiacas sao marcadores altamente sensiveis e especificos de lesao miocardica. Esses marcadores foram detectados na insuficiencia cardiaca (IC) e estao associadas com mau prognostico. OBJETIVO: Avaliar a relacao da troponina T (cTnT) e suas faixas de valores com o prognostico na IC descompensada. METODOS: Estudaram-se 70 pacientes com piora da IC cronica que necessitaram de hospitalizacao. Na admissao, o modelo de Cox foi utilizado para avaliar as variaveis capazes de predizer o desfecho composto por morte ou re-hospitalizacao em razao de piora da IC durante um ano. RESULTADOS: Durante o seguimento, ocorreram 44 mortes, 36 re-hospitalizacoes por IC e 56 desfechos compostos. Na analise multivariada, os preditores de eventos clinicos foram: cTnT (cTnT > 0,100 ng/ml; hazard ratio (HR) 3,95 intervalo de confianca (IC) 95%: 1,64-9,49, p = 0,002), diâmetro diastolico final do ventriculo esquerdo (DDVE >70 mm; HR 1,92, IC95%: 1,06-3,47, p = 0,031) e sodio serico (Na 0,020 e 0,100 ng/ml, n = 12). As probabilidades de sobrevida e sobrevida livre de eventos foram: 54,2%, 31,5%, 16,7% (p = 0,020), e 36,4%, 11,5%, 8,3% (p = 0,005), respectivamente. CONCLUSAO: A elevacao da cTnT esta associada com mau prognostico na IC descompensada, e o grau dessa elevacao pode facilitar a estratificacao de risco.BACKGROUND The cardiac troponins are highly sensitive and specific markers of myocardial injury. They have been detected in heart failure (HF) and are associated with a bad prognosis. OBJECTIVE To evaluate the association of cardiac troponin T (cTnT) and its ranges with prognosis in decompensated HF. METHODS A total of 70 patients with chronic HF worsening that needed hospitalization were studied. Cox model was used to evaluate the variables at admission capable of predicting the combined outcome that consisted of death or re-hospitalization due to HF worsening during a 1-year follow-up. RESULTS During the follow-up, there were 44 deaths, 36 re-hospitalizations due to HF and 56 combined outcomes. At the multivariate analysis, the predictors of clinical events were the cTnT (cTnT > or = 0.100 ng/mL; hazard ratio [HR] 3.95 95% confidence interval [CI]: 1.64-9.49, p = 0.002), left ventricular end diastolic diameter (LVDD > or = 70 mm; HR 1.92, 95%CI: 1.06-3.47, p = 0.031) and serum sodium (Na < 135 mEq/L; HR 1.79, 95%CI: 1.02-3.15, p = 0.044). To evaluate the association between the cTnT increase and the prognosis in decompensated HF, the patients were stratified in three groups: low-cTnT (cTnT <0.020 ng/ml, n = 22), intermediate-cTnT (cTnT > 0.020 and < 0.100 ng/ml, n = 36), and high-cTnT (cTnT > or = 0.100 ng/ml, n = 12).The probabilities of survival and event-free survival were 54.2%, 31.5%, 16.7% (p = 0.020) and 36.4%, 11.5%, 8.3% (p = 0.005), respectively. CONCLUSION The increase in cTnT is associated with a bad prognosis in decompensated HF and the degree of this increase can help the risk stratification.

Serum NT-proBNP levels are a prognostic predictor in patients with advanced heart failure

OBJECTIVE: To verify if the determination of NT-proBNP values would help predict the prognosis in advanced heart failure (HF) patients. METHODS: One hundred and five subjects with average age of 52.4 years were evaluated, 66.6% of them males. Thirty-three (32.0%) subjects were outpatients and 70 (67.9%) were inpatients (functional class III/IV) admitted to the hospital for cardiac compensation. All patients had left ventricular systolic dysfunction and a mean ejection fraction of 0.29. The NT-proBNP levels were measured in all patients and they were followed-up over a period from 2 to 90 days (average 77 days). A ROC curve was drawn to determine the best cut-off point, as well as the corresponding Kaplan-Meyer survival curves. RESULTS: During the follow-up period, 22 patients died. The average NT-proBNP value of the patients who remained alive was 6,443.67±6,071.62 pg/ml, whereas that of those who died was 14,609.66±12,165.15 pg/ml (p=0.001). The ROC curve identified a cut-off point at 6,000 pg/ml with 77.3% sensitivity (area under the curve: 0.74). The survival curve for values below and above 6,000 pg/ml was significantly different (p=0.002): patients with values below 6,000 pg/ml had a 90.2% 90-day survival, and those patients with values above, a 66% survival. CONCLUSION: Patients with advanced HF, especially those admitted to the hospital for cardiac compensation, had much higher NT-proBNP values, with a two-fold increase among those who died during the follow-up period. Values above 6,000 pg/ml identify the patients most likely to die within 90 days after hospital discharge.OBJECTIVE To verify if the determination of NT-proBNP values would help predict the prognosis in advanced heart failure (HF) patients. METHODS One hundred and five subjects with average age of 52.4 years were evaluated, 66.6% of them males. Thirty-three (32.0%) subjects were outpatients and 70 (67.9%) were inpatients (functional class III/IV) admitted to the hospital for cardiac compensation. All patients had left ventricular systolic dysfunction and a mean ejection fraction of 0.29. The NT-proBNP levels were measured in all patients and they were followed-up over a period from 2 to 90 days (average 77 days). A ROC curve was drawn to determine the best cut-off point, as well as the corresponding Kaplan-Meyer survival curves. RESULTS During the follow-up period, 22 patients died. The average NT-proBNP value of the patients who remained alive was 6,443.67+/-6,071.62 pg/ml, whereas that of those who died was 14,609.66+/-12,165.15 pg/ml (p=0.001). The ROC curve identified a cut-off point at 6,000 pg/ml with 77.3% sensitivity (area under the curve: 0.74). The survival curve for values below and above 6,000 pg/ml was significantly different (p=0.002): patients with values below 6,000 pg/ml had a 90.2% 90-day survival, and those patients with values above, a 66% survival. CONCLUSION Patients with advanced HF, especially those admitted to the hospital for cardiac compensation, had much higher NT-proBNP values, with a two-fold increase among those who died during the follow-up period. Values above 6,000 pg/ml identify the patients most likely to die within 90 days after hospital discharge.

Troponina cardiaca T para estratificación de riesgo en la insuficiencia cardiaca crónica descompensada

FUNDAMENTO: As troponinas cardiacas sao marcadores altamente sensiveis e especificos de lesao miocardica. Esses marcadores foram detectados na insuficiencia cardiaca (IC) e estao associadas com mau prognostico. OBJETIVO: Avaliar a relacao da troponina T (cTnT) e suas faixas de valores com o prognostico na IC descompensada. METODOS: Estudaram-se 70 pacientes com piora da IC cronica que necessitaram de hospitalizacao. Na admissao, o modelo de Cox foi utilizado para avaliar as variaveis capazes de predizer o desfecho composto por morte ou re-hospitalizacao em razao de piora da IC durante um ano. RESULTADOS: Durante o seguimento, ocorreram 44 mortes, 36 re-hospitalizacoes por IC e 56 desfechos compostos. Na analise multivariada, os preditores de eventos clinicos foram: cTnT (cTnT > 0,100 ng/ml; hazard ratio (HR) 3,95 intervalo de confianca (IC) 95%: 1,64-9,49, p = 0,002), diâmetro diastolico final do ventriculo esquerdo (DDVE >70 mm; HR 1,92, IC95%: 1,06-3,47, p = 0,031) e sodio serico (Na 0,020 e 0,100 ng/ml, n = 12). As probabilidades de sobrevida e sobrevida livre de eventos foram: 54,2%, 31,5%, 16,7% (p = 0,020), e 36,4%, 11,5%, 8,3% (p = 0,005), respectivamente. CONCLUSAO: A elevacao da cTnT esta associada com mau prognostico na IC descompensada, e o grau dessa elevacao pode facilitar a estratificacao de risco.BACKGROUND The cardiac troponins are highly sensitive and specific markers of myocardial injury. They have been detected in heart failure (HF) and are associated with a bad prognosis. OBJECTIVE To evaluate the association of cardiac troponin T (cTnT) and its ranges with prognosis in decompensated HF. METHODS A total of 70 patients with chronic HF worsening that needed hospitalization were studied. Cox model was used to evaluate the variables at admission capable of predicting the combined outcome that consisted of death or re-hospitalization due to HF worsening during a 1-year follow-up. RESULTS During the follow-up, there were 44 deaths, 36 re-hospitalizations due to HF and 56 combined outcomes. At the multivariate analysis, the predictors of clinical events were the cTnT (cTnT > or = 0.100 ng/mL; hazard ratio [HR] 3.95 95% confidence interval [CI]: 1.64-9.49, p = 0.002), left ventricular end diastolic diameter (LVDD > or = 70 mm; HR 1.92, 95%CI: 1.06-3.47, p = 0.031) and serum sodium (Na < 135 mEq/L; HR 1.79, 95%CI: 1.02-3.15, p = 0.044). To evaluate the association between the cTnT increase and the prognosis in decompensated HF, the patients were stratified in three groups: low-cTnT (cTnT <0.020 ng/ml, n = 22), intermediate-cTnT (cTnT > 0.020 and < 0.100 ng/ml, n = 36), and high-cTnT (cTnT > or = 0.100 ng/ml, n = 12).The probabilities of survival and event-free survival were 54.2%, 31.5%, 16.7% (p = 0.020) and 36.4%, 11.5%, 8.3% (p = 0.005), respectively. CONCLUSION The increase in cTnT is associated with a bad prognosis in decompensated HF and the degree of this increase can help the risk stratification.

Is There Any Relationship between TSH Levels and Prognosis in Acute Coronary Syndrome

Background Some small studies have related higher levels of thyrotropin (TSH) to potentially worse prognosis in acute coronary syndromes. However, this relationship remains uncertain. Objective To analyze the outcomes of patients with acute coronary syndromes in relation to the value of TSH at admission. Methods Observational and retrospective study with 505 patients (446 in group I [TSH ≤ 4 mIU/L] and 59 in group II [TSH > 4 mIU/L]) with acute coronary syndromes between May 2010 and May 2014. We obtained data about comorbidities and the medications used at the hospital. The primary endpoint was in-hospital all-cause death. The secondary endpoint included combined events (death, non-fatal unstable angina or myocardial infarction, cardiogenic shock, bleeding and stroke). Comparisons between groups were made by one-way ANOVA and chi-square test. Multivariate analysis was determined by logistic regression. Analyses were considered significant when p < 0.05. Results Significant differences between groups I and II were observed regarding the use of enoxaparin (75.2% vs. 57.63%, p = 0.02) and statins (84.08% vs. 71.19%, p < 0.0001), previous stroke (5.83% vs. 15.25%, p = 0.007), combined events (14.80% vs. 27.12%, OR = 3.05, p = 0.004), cardiogenic shock (4.77% vs. 6.05%, OR = 4.77, p = 0.02) and bleeding (12.09% vs. 15.25%, OR = 3.36, p = 0.012). Conclusions In patients with acute coronary syndromes and TSH > 4 mIU/L at admission, worse prognosis was observed, with higher incidences of in-hospital combined events, cardiogenic shock and bleeding.

Infection in Patients with Decompensated Heart Failure: In-Hospital Mortality and Outcome

Background Heart failure (HF) is a syndrome, whose advanced forms have a poor prognosis, which is aggravated by the presence of comorbidities. Objective We assessed the impact of infection in patients with decompensated HF admitted to a tertiary university-affiliated hospital in the city of São Paulo. Methods This study assessed 260 patients consecutively admitted to our unit because of decompensated HF. The presence of infection and other morbidities was assessed, as were in-hospital mortality and outcome after discharge. The chance of death was estimated by univariate logistic regression analysis of the variables studied. The significance level adopted was P < 0.05. Results Of the patients studied, 54.2% were of the male sex, and the mean age ± SD was 66.1 ± 12.7 years. During hospitalization, 119 patients (45.8%) had infection: 88 (33.8%) being diagnosed with pulmonary infection and 39 patients (15.0%), with urinary infection. During hospitalization, 56 patients (21.5%) died, and, after discharge, 36 patients (17.6%). During hospitalization, 26.9% of the patients with infection died vs 17% of those without infection (p = 0.05). However, after discharge, mortality was lower in the group that had infection: 11.5% vs 22.2% (p = 0.046). Conclusions Infection is a frequent morbidity among patients with HF admitted for compensation of the condition, and those with infection show higher in-hospital mortality. However, those patients who initially had infection and survived had a better outcome after discharge.

Prognostic Differences between Men and Women with Acute Coronary Syndrome. Data from a Brazilian Registry

Background Gender-related differences have been reported in patients with acute coronary syndrome. The description of this comparative finding in a Brazilian registry has not yet been documented. Objective To compare male vs. female patients regarding the baseline characteristics, coronary findings, treatment and in-hospital and long-term prognosis. Methods This is a retrospective, multicenter and observational study that included 3,745 patients (2,437 males and 1,308 females) between May 2010 and May 2015. The primary in-hospital outcome was all-cause mortality. The secondary outcome consisted of combined events (cardiogenic shock, reinfarction, death, stroke and bleeding). The comparison between groups was performed using the chi-square and the t test, considering p < 0.05 as significant. In the long term, mortality and combined events were assessed using the Kaplan-Meier method, with a mean follow-up of 8.79 months. Results The mean age was 60.3 years for males and 64.6 for females (p < 0.0001). The most prevalent risk factor was systemic arterial hypertension in 72.9% of the women and 67.8% of the men (p = 0.001). Percutaneous coronary intervention was carried out in 44.9% of the males and 35.4% of the females (p < 0.0001), and coronary artery bypass grafting (CABG) was performed in 17% of the males and 11.8% of females (p < 0.0001), with a higher prevalence of three-vessel coronary artery disease in males (27.3% vs. 16.2%, p < 0.0001). Approximately 79.9% of the female patients received a diagnosis of acute coronary syndrome without ST-segment elevation, while in the male patients, this diagnosis was attained in 71.5% (p < 0.0001). No significant differences were observed between the groups in the short and long term, regarding both mortality and the combined events. Conclusion Several gender-related differences were observed in patients with acute coronary syndrome regarding the demographic characteristics, coronary artery disease pattern and implemented treatment. However, the prognostic evolution was similar between the groups.