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. 2025 Oct 31:qcaf130.
doi: 10.1093/ehjqcco/qcaf130. Online ahead of print.

"Sex-Based Differences in Heart Failure Development During STEMI hospitalisation"

Antonia Sambola  1   2   3 , Laia Milà  1   3 , Eduard Ródenas-Alesina  1   3 , María Vidal-Burdeus  1   3 , Bruno García Del Blanco  1   3 , Augusto Sao  1   3 , Cosme García-García  4 , Montserrat Vila-Perales  3   5 , Rut Andrea  6 , Pedro Cepas-Guillén  6 , Alessandro Sionis  2   3   5 , Albert Ariza  7 , Carlos Tomás  8 , José A Barrabés  1   2   3
Affiliations

"Sex-Based Differences in Heart Failure Development During STEMI hospitalisation"

Antonia Sambola et al. Eur Heart J Qual Care Clin Outcomes. .

Abstract

Background: Sex-related differences in the development of heart failure (HF) during hospitalization for ST-segment elevation myocardial infarction (STEMI) remain underexplored. This study aimed to assess sex-specific differences in the development of in-hospital HF among STEMI patients admitted in Killip class I and evaluate its impact on in-hospital mortality.

Methods: We analysed data from a prospective, multicentre registry across six teaching hospitals. The primary outcome was the development of HF during hospitalization in patients initially classified as Killip class I. The secondary outcome was in-hospital mortality. Multivariable logistic regression identified factors associated with in-hospital HF.

Results: Among 1,279 STEMI patients (22.9% women), 201 (15.8%) presented with HF at admission, more commonly in women than in men (23.9% vs. 17.4%, p<0.001). Of the 985 patients admitted in Killip class I, 45 (4.6%) developed HF during hospitalization-more frequently in women (7.9% vs. 3.6%, p<0.001). Female sex (OR 3.09; 95% CI, 1.46-6.53), multivessel disease (OR 2.19; 95% CI, 1.06-4.56), and out-of-hospital cardiac arrest (OR 4.76; 95% CI, 1.04-21.71) were independently associated with HF development. Higher left ventricular ejection fraction was protective (OR 0.92; 95% CI, 0.87-0.93). Age and final TIMI flow <3 were not associated. While HF was linked to increased mortality in men, the sex-mortality interaction was not statistically significant (p=0.108).

Conclusions: Women with STEMI admitted in Killip class I had a higher risk of developing in-hospital HF. However, HF had a similar impact on mortality in both sexes.

Keywords: heart failure; myocardial infarction; prognosis; sex; women.

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