Objective Acute coronary syndrome(ACS) is common in women,yet we have less gender-specific data in women than in men as a result of lower enrollment in clinical trials.The purpose of this study was to assess gender-based differences in presentation and outcome after ACS in clinical practice in China.Methods A total of 12 hospitals were represented in Chinese Registry of Acate Coronary Events.Data collection began in 2001,up to 2003,1301 patients with ACS enrolled into the study.We compared the clinical demographics,different therapies and outcome in hospital between female and male patients with ACS.Results Patients with age 27-93(63.13±10.89) years including 318 female and 983 male subjects were enrolled.Female subjects were older than male patients(67.23 yrs vs 61.80 yrs);the incidence of history of angina,heart failure,diabetes mellitus and hypertension in female group was significantly higher than that in male group(73.6% vs 62.3%,8.2% vs 5.7%,30.8% vs 18.6%,and 66.4% vs 56.8%,respectively),but the incidence of smoking in female group was significantly less than that in male group(6.6% vs 66.2%).More male patients were presented with ST segment elevation myocardial infarction(STEMI) compared with female patients(48.5% vs 39%).With the exception of β-blocker administration,no differences were found about medications including aspirin,angiotensin converting enzyme inhibitor,lipid lowering agents and low molecular weight heparin between female and male patients.Compared with male patients with non ST segment elevation ACS(NSTE-ACS),female subjects were prone to receive β-blocker(63.4% vs 75.1%).Not only for STEMI but also for NSTE-ACS patients,more female subjects received less reperfusion therapies compared with male subjects(37.1% vs 26.8% for STEMI;53.6% vs 37.2 % for NSTE-ACS);recurrent angina was more often in female group with the whole spectrum of ACS(25.0% vs 14.5% for STEMI;29.4% vs 20.2% for NSTE-ACS),and so did the occurrence of congestive heart failure.There was no difference of in-hospital death rate between the two groups with ACS(5.6% vs 7.1% for STEMI,and 2.1% vs 1.4% for NSTE-ACS).Conclusion Female patients with ACS are older than male subjects and thus more often have concomitant diseases but less often have a history of smoking.They less often receive reperfusion therapies,however,there is no difference about in-hospital mortality between the female and male patients.