Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 22;119(16):284-292.
doi: 10.3238/arztebl.m2022.0161.

ST-Elevation Myocardial Infarction as a First Event

Alicia Jeanette Fischer  1 , Jannik Feld, Lena Makowski, Christiane Engelbertz, Leonie Kühnemund, Christian Günster, Patrik Dröge, Thomas Ruhnke, Joachim Gerß, Eva Freisinger, Holger Reinecke, Jeanette Köppe
Affiliations

ST-Elevation Myocardial Infarction as a First Event

Alicia Jeanette Fischer et al. Dtsch Arztebl Int. .

Abstract

Background: Survival after ST-elevation myocardial infarction (STEMI) as a first event in Germany was analyzed.

Methods: Adults with a first-event STEMI were included for analysis on the basis of insurance data from a German health insurance provider (AOK; approximately 26 million members; median follow-up 48.5 months). The primary endpoints were 30-day mortality, reinfarction or death, major adverse cardiovascular and cerebro - vascular events (MACCE), long-term survival for more than 90 days, and overall survival (OS).

Results: STEMI occurred in 17 444 patients (32.8% women). The women were older than the men (median age 74 versus 60 years) and suffered more frequently from cardiovascular comorbidities such as diabetes mellitus, chronic renal disease, and arterial hypertension. Women underwent endovascular or surgical treatment less frequently, but sustained complications (cardiogenic shock, resuscitation) more frequently. After adjustment of the data, women were at higher risk of 30-day mortality (odds ratio [OR] 1.17, 95% confidence interval [95% CI] [1.07; 1.28]), reinfarction or death (hazard ratio [HR] 1.09, 95% CI [1.04; 1.16]), MACCE (HR 1.09, 95% CI [1.04; 1.15]), and poorer OS (HR 1.10, 95% CI [1.04; 1.17]). This effect was especially pronounced in women aged ≤ 60 years. No differences between the sexes were seen among patients who survived for 90 days after the infarction.

Conclusion: In Germany, women ≤ 60 years display a higher 30-day mortality after first-event STEMI, which affects their overall survival. Younger women should receive intensified medical attention after STEMI, especially in the early phase.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan–Meier estimates for overall survival after first STEMI, stratified by sex and age a) Age < 40 years; b) 40–59 years; c) ≥ 60 years; d) all patients STEMI, ST-elevation myocardial infarction
Figure 2
Figure 2
Adjusted odds/hazard ratios presenting the association of sex with different endpoints depending on age after first event of STEMI, determined by multivariable logistic regression model (30-day mortality) and Cox Regression model including age, sex and patient risk factors. Therefore, age was categorized into six groups (<50, 50 – 59, 50 – 69, 70 – 79, 80 – 89, >89 years) and the interaction between age group and sex was also included to the models (CI=confidence interval, MACCE=cardiovascular and cerebrovascular events, OR. Odds Ratio, HR. Hazard Ratio).
eFigure 1
eFigure 1
Study design STEMI, ST-elevation myocardial infarction
eFigure 2
eFigure 2
Kaplan–Meier estimates for overall survival after first STEMI, stratified by sex and age a) Age < 40 years; b) 40–49 years; c) 50–59 years; d) 60– 69 years; e) 70–79 years; f) 80– 89 years; g) ≥ 90 years; h) all patients STEMI, ST-elevation myocardial infarction
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med. 2011,;124:40–47. - PMC - PubMed
    1. Yeh RW, Sidney S, Chandra M, Sorel M, Selby JV, Go AS. Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med. 2010,;362:2155–2165. - PubMed
    1. Mc Namara K, Alzubaidi H, Jackson JK. Cardiovascular disease as a leading cause of death: how are pharmacists getting involved? Integr Pharm Res Pract. 2019,;8:1–11. - PMC - PubMed
    1. Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016,;37:3232–3245. - PubMed
    1. Regitz-Zagrosek V, Oertelt-Prigione S, Prescott E, et al. Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes. Eur Heart J. 2016,;37:24–34. - PubMed