Management of Acute Coronary Syndromes: Is the Yentl Syndrome Vanishing?

Background The term Yentl syndrome , coined by Bernadine Healy in 1991, refers to the disparities in the management of acute myocardial infarction between men and women. Using data from the Swiss nationwide AMIS Plus (Acute Myocardial Infarction in Switzerland) registry, we analyzed temporal trends of this sex gap. Methods The AMIS Plus registry includes patients with acute myocardial infarction admitted to 84 Swiss hospitals. We analyzed sex differences in the use of percutaneous coronary intervention across 3 consecutive 6‐year periods (2007–2012, 2013–2018, 2019–2024), separately for ST‐segment–elevation myocardial infarction (STEMI) and non‐STEMI. Results Between January 2007 and December 2024, a total of 48 357 patients were enrolled. Of these, 36 169 were men (74.8%) and 12 188 women (25.2%). STEMI and non‐STEMI comprised 57.6% and 42.4% of the population, respectively. Across all three 6‐year periods, men were more likely to undergo percutaneous coronary intervention for both STEMI and non‐STEMI ( P <0.001) than women. However, the sex gap narrowed significantly over time: in patients with STEMI from 8.8% (95% CI, 8.0%–9.6%) in 2007 through 2012, to 3.2% (95% CI, 2.7%–3.9%) in 2013 through 2018, and 2.7% (95% CI, 2.0%–3.5%) in 2019 through 2024, and in patients with non‐STEMI from 14.8% (95% CI, 13.8%–16.0%) to 6.3% (95% CI, 5.4%–7.2%) and 7.4% (95% CI, 6.2%–8.7%) over the same periods. Conclusions In this nationwide prospective registry, we observed a marked reduction in sex‐related disparities in percutaneous coronary intervention use among patients with myocardial infarction in Switzerland from 2007 to 2024. These findings offer hope that the long shadow of the Yentl syndrome finally may be receding. REGISTRATION URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01305785.