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. 2022 Sep 6;11(17):e025959.
doi: 10.1161/JAHA.122.025959. Epub 2022 Aug 26.

Incidence, Characteristics, and Outcomes of Ventricular Fibrillation Complicating Acute Myocardial Infarction in Women Admitted Alive in the Hospital

Orianne Weizman  1   2 , Eloi Marijon  1   3 , Kumar Narayanan  1 , Serge Boveda  4 , Pascal Defaye  5 , Raphael Martins  6 , Jean-Claude Deharo  7 , Gabriel Laurent  8 , Didier Klug  9 , Nicolas Sadoul  10 , Meleze Hocini  11 , Nicolas Mansencal  12 , Frédéric Anselme  13 , Antoine Da Costa  14 , Philippe Maury  15 , Jean Ferrières  15 , François Schiele  16 , Tabassome Simon  17 , Nicolas Danchin  1   3 ; FAST‐MI Program Investigators
Affiliations

Incidence, Characteristics, and Outcomes of Ventricular Fibrillation Complicating Acute Myocardial Infarction in Women Admitted Alive in the Hospital

Orianne Weizman et al. J Am Heart Assoc. .

Abstract

Background Little data are available in women presenting with ventricular fibrillation (VF) in the setting of acute myocardial infarction (AMI). We assessed frequency, predictors of VF, and outcomes, with a special focus on women compared with men. Methods and Results Data were analyzed from the FAST-MI (French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction) program, which prospectively included 14 406 patients admitted to French cardiac intensive care units ≤48 hours from AMI onset between 1995 and 2015 (mean age, 66±14 years; 72% men; mean left ventricular ejection fraction, 52±12%; 59% with ST-segment-elevation myocardial infarction). A total of 359 patients developed VF during AMI, including 81 women (2.0% of 4091 women) and 278 men (2.7% of 10 315 men, P=0.02). ST-segment-elevation myocardial infarction (odds ratio [OR], 2.29 [95% CI, 1.75-2.99]; P<0.001) was independently associated with the onset of VF during AMI. In contrast, female sex (OR, 0.73 [95% CI, 0.56-0.95]; P=0.02), hypertension (OR, 0.75 [95% CI, 0.60-0.94]; P=0.01), and prior myocardial infarction (OR, 0.69 [95% CI, 0.50-0.96]; P=0.03) were protective factors. Women were less likely to have cardiac intervention than men (percutaneous coronary intervention during hospitalization 48.1% versus 66.9%, respectively; P=0.04) with a higher 1-year mortality in women compared with men (50.6% versus 37.4%, respectively; P=0.03), including increased in-hospital mortality (42.0% versus 32.7%, respectively; P=0.12). After adjustment, female sex was no longer associated with a worse 1-year mortality (adjusted hazard ratio, 1.10 [95% CI, 0.75-1.61]; P=0.63). Conclusions Women have lower risk of developing VF during AMI compared with men. However, they are less likely to receive cardiac interventions than men, possibly contributing to missed opportunities of improved outcomes.

Keywords: myocardial infarction; sex; sudden cardiac death; women.

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Figures

Figure 1
Figure 1
Flowchart of the study population. AMI indicates acute myocardial infarction; and VF, ventricular fibrillation.
Figure 2
Figure 2
Kaplan‐Meir curves of survival according to ventricular fibrillation (VF) status and sex. HR indicates hazard ratio.
See this image and copyright information in PMC

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