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. 2023 Jan;59(1):61-69.
doi: 10.4068/cmj.2023.59.1.61. Epub 2023 Jan 25.

Impact of Comorbid Disease Burden on Clinical Outcomes of Female Acute Myocardial Infarction Patients

Jeong Shim Kim  1   2 , Seok Oh  1   2 , Myung Ho Jeong  1   2   3 , Seok-Joon Sohn  4
Affiliations

Impact of Comorbid Disease Burden on Clinical Outcomes of Female Acute Myocardial Infarction Patients

Jeong Shim Kim et al. Chonnam Med J. 2023 Jan.

Abstract

Owing to the paucity of information on the clinical outcomes in female patients with acute myocardial infarction (AMI) in relation to the comorbid disease burden, we explored the differences in their clinical outcomes and identified predictive indicators. A total of 3,419 female AMI patients were stratified into two groups: Group A (those with zero or one comorbid diseases) (n=1,983) and Group B (those with two to five comorbid diseases) (n=1,436). Five comorbid conditions were considered: hypertension, diabetes mellitus, dyslipidemia, prior coronary artery disease, and prior cerebrovascular accidents. The primary outcome was major adverse cardiac and cerebrovascular events (MACCEs). The incidence of MACCEs was higher in Group B than in Group A in both the unadjusted and propensity score-matched data. Among the comorbid conditions, hypertension, diabetes mellitus, and prior coronary artery disease were found to be independently associated with an increased incidence of MACCEs. Higher comorbid disease burden was positively associated with adverse outcomes in the female population with AMI. Since both hypertension and diabetes mellitus are modifiable and independent predictors of adverse outcomes after AMI, it may be necessary to focus on the optimal management of blood pressure and glucose levels to improve cardiovascular outcomes.

Keywords: Female; Multimorbidity; Myocardial infarction; Treatment outcome.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT: None declared.

Figures

FIG. 1
FIG. 1. Study population flow chart. Female patients with AMI were categorized into two groups according to their comorbid disease burden: Group A (those with zero or one comorbid disease) (n=1,983) and Group B (those with two to five comorbid diseases) (n=1,436). Five comorbid conditions were considered: HTN, DM, DL, prior CAD, and prior CVA. AMI: acute myocardial infarction, CAD: coronary artery disease, CVA: cerebrovascular accident, DL: dyslipidemia, DM: diabetes mellitus, HTN: hypertension, KAMIR-NIH: Korea Acute Myocardial Infarction-National Institutes of Health.
FIG. 2
FIG. 2. The number of comorbid disease burden in female patients with confirmed AMI. AMI: acute myocardial infarction.
FIG. 3
FIG. 3. Event rates of MACCE for all the patients after a 3-year follow-up (before and after PSM-adjusted analysis). Kaplan–Meier curves are shown for cumulative event rates stratified according to comorbidity burden. MACCE: major adverse cardiac and cerebrovascular accident, PSM: propensity score matching.
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