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Subject: ST-segment elevation myocardial infarction; heart failure; outcomes; sex differences.


Year: 2019


Type: Dataset



Title: Sex-Related Differences in Heart Failure After ST-Segment Elevation Myocardial Infarction


Author: Cenko, Edina
Author: van der Schaar, Mihaela
Author: Yoon, Jinsung
Author: Manfrini, Olivia
Author: Vasiljevic, Zorana
Author: Vavlukis, Marija
Author: Kedev, Sashko
Author: Miličić, Davor
Author: Badimon, Lina
Author: Bugiardini, Raffaele



Abstract: Background: ST-segment elevation myocardial infarction (STEMI) complicated by symptoms of acute de novo heart failure is associated with excess mortality. Whether development of heart failure and its outcomes differ by sex is unknown. Objectives: This study sought to examine the relationships among sex, acute heart failure, and related outcomes after STEMI in patients with no prior history of heart failure recorded at baseline. Methods: Patients were recruited from a network of hospitals in the ISACS-TC (International Survey of Acute Coronary Syndromes in Transitional Countries) registry (NCT01218776). Main outcome measures were incidence of Killip class ≥II at hospital presentation and risk-adjusted 30-day mortality rates were estimated using inverse probability of weighting and logistic regression models. Results: This study included 10,443 patients (3,112 women). After covariate adjustment and matching for age, cardiovascular risk factors, comorbidities, disease severity, and delay to hospital presentation, the incidence of de novo heart failure at hospital presentation was significantly higher for women than for men (25.1% vs. 20.0%, odds ratio [OR]: 1.34; 95% confidence interval [CI]: 1.21 to 1.48). Women with de novo heart failure had higher 30-day mortality than did their male counterparts (25.1% vs. 20.6%; OR: 1.29; 95% CI: 1.05 to 1.58). The sex-related difference in mortality rates was still apparent in patients with de novo heart failure undergoing reperfusion therapy after hospital presentation (21.3% vs. 15.7%; OR: 1.45; 95% CI: 1.07 to 1.96). Conclusions: Women are at higher risk to develop de novo heart failure after STEMI and women with de novo heart failure have worse survival than do their male counterparts. Therefore, de novo heart failure is a key feature to explain mortality gap after STEMI among women and men.


Publisher: Elsevier BV


Relation: Journal of the American College of Cardiology



Identifier: oai:repository.ukim.mk:20.500.12188/12704
Identifier: http://hdl.handle.net/20.500.12188/12703
Identifier: 19
Identifier: https://api.elsevier.com/content/article/PII:S073510971937651X?httpAccept=text/xml
Identifier: https://api.elsevier.com/content/article/PII:S073510971937651X?httpAccept=text/plain
Identifier: 74
Identifier: 10.1016/j.jacc.2019.08.1047
Identifier: https://api.elsevier.com/content/article/PII:S073510971937651X?httpAccept=text/xml
Identifier: https://api.elsevier.com/content/article/PII:S073510971937651X?httpAccept=text/plain
Identifier: 74
Identifier: 19



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Sex-Related Differences in Heart Failure After ST-Segment Elevation Myocardial Infarction201930