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. 2013 Jun 20;9(3):427-33.
doi: 10.5114/aoms.2013.35324. Epub 2013 May 27.

Higher mortality in women after ST-segment elevation myocardial infarction in very young patients

Marcin Sadowski  1 , Agnieszka Janion-Sadowska, Mariusz Gąsior, Marek Gierlotka, Marianna Janion, Lech Poloński
Affiliations

Higher mortality in women after ST-segment elevation myocardial infarction in very young patients

Marcin Sadowski et al. Arch Med Sci. .

Abstract

Introduction: Data on mortality in young patients with ST-segment elevation myocardial infarction (STEMI) when compared to older people or regarding therapeutic strategies are contradictory. We investigate the prognosis of women under 40 after STEMI in a prospective nationwide acute coronary syndrome registry.

Material and methods: We analyzed all 527 consecutive men and women (12.3% females) aged from 20 to 40 years (mean 35.7 ±4.5) presenting with STEMI, of all 26035 STEMI patients enrolled.

Results: Differences between genders in the major cardiovascular risk factors, clinical presentation, extent of the disease and time to reperfusion were insignificant. The majority of patients (67%) underwent coronary angiography followed by primary percutaneous coronary intervention (PCI) in 79.9% of them. A 92% reperfusion success rate measured by post-procedural TIMI 3 flow was achieved. There were no significant differences between genders in the administration of modern pharmacotherapy both on admission and after discharge from hospital. In-hospital mortality was very low in both genders, but 12-month mortality was significantly higher in women (10.8% vs. 3.0%; p = 0.003). Killip class 3 or 4 on admission (95% CI 19.6-288.4), age per 5-year increase (95% CI 1.01-3.73) and primary PCI (95% CI 0.1-0.93) affected mortality. In patients who underwent reperfusion there was moderately higher mortality in women than in men (7.1% vs. 1.9%; p = 0.046).

Conclusions: Despite little difference in the basic clinical characteristics and the management including a wide use of primary PCI, long-term mortality in women under forty after STEMI is significantly higher than in men.

Keywords: ST-segment elevation myocardial infarction; gender-related difference; mortality; myocardial infarction; young.

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Figures

Figure 1
Figure 1
Kaplan-Meier 1-year mortality curves in men and women
Figure 2
Figure 2
One-year mortality – a multivariate analysis
Figure 3
Figure 3
Kaplan-Meier 1-year mortality curves in patients who underwent reperfusion
See this image and copyright information in PMC

References

    1. Stramba-Badiale M, Fox KM, Priori SG, et al. Cardiovascular diseases in women: a statement from the policy conference of the European Society of Cardiology. Eur Heart J. 2006;27:994–1005. - PubMed
    1. Cengel A, Tanindi A. Myocardial infarction in the young. J Postgrad Med. 2009;55:305–13. - PubMed
    1. Sakowicz A, Fendler W, Lelonek M, Pietrucha T. Genetic variability and the risk of myocardial infarction in Poles under 45 years of age. Arch Med Sci. 2010;6:160–7. - PMC - PubMed
    1. Hasdai D, Behar S, Wallentin L, et al. A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin; the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS) Eur Heart J. 2002;23:1190–201. - PubMed
    1. Rosengren A, Wallentin L, K Gitt A, et al. Sex, age, and clinical presentation of acute coronary syndromes. Eur Heart J. 2004;25:663–70. - PubMed