Risks of age and sex on clinical outcomes post myocardial infarction.
Age
Cardiac structure
Gender
MI
Journal
International journal of cardiology. Heart & vasculature
ISSN: 2352-9067
Titre abrégé: Int J Cardiol Heart Vasc
Pays: Ireland
ID NLM: 101649525
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
14
10
2018
revised:
17
03
2019
accepted:
18
03
2019
entrez:
13
4
2019
pubmed:
13
4
2019
medline:
13
4
2019
Statut:
epublish
Résumé
How sex and age influence post-myocardial infarction (post-MI) outcomes remains unclear. This study evaluated the influence of sex and age on drug therapy, echocardiographic parameters, and outcomes in post-MI patients undergoing percutaneous coronary intervention (PCI). We retrospectively enrolled 643 patients with first acute MI who underwent successful PCI and two echocardiographic examinations within 1 year after MI. Clinical characteristics and 4-year follow-up outcomes were compared between sexes and age groups. Primary endpoints were cardiovascular mortality and hospitalization for heart failure (HF). Compared with males, female patients with MI, particularly older females, had more systemic diseases. Younger females received fewer guideline-directed therapies. Older patients presented with higher left ventricular volume and mass index but no significant differences in left ventricular ejection fraction. The Kaplan-Meier analysis revealed increased mortality in both younger and older females. Elderly patients, particularly older females, exhibited significantly higher post-MI HF incidence but no difference in recurrent MI, ventricular arrhythmia, or revascularization. In MI patients receiving PCI, outcome differences between sexes are age-dependent. Age influences outcome more heavily in females than in males. Females are likely to exhibit worse overall survival, and older females are at higher risk of post-MI HF.
Sections du résumé
BACKGROUND
BACKGROUND
How sex and age influence post-myocardial infarction (post-MI) outcomes remains unclear. This study evaluated the influence of sex and age on drug therapy, echocardiographic parameters, and outcomes in post-MI patients undergoing percutaneous coronary intervention (PCI).
METHODS
METHODS
We retrospectively enrolled 643 patients with first acute MI who underwent successful PCI and two echocardiographic examinations within 1 year after MI. Clinical characteristics and 4-year follow-up outcomes were compared between sexes and age groups. Primary endpoints were cardiovascular mortality and hospitalization for heart failure (HF).
RESULTS
RESULTS
Compared with males, female patients with MI, particularly older females, had more systemic diseases. Younger females received fewer guideline-directed therapies. Older patients presented with higher left ventricular volume and mass index but no significant differences in left ventricular ejection fraction. The Kaplan-Meier analysis revealed increased mortality in both younger and older females. Elderly patients, particularly older females, exhibited significantly higher post-MI HF incidence but no difference in recurrent MI, ventricular arrhythmia, or revascularization.
CONCLUSIONS
CONCLUSIONS
In MI patients receiving PCI, outcome differences between sexes are age-dependent. Age influences outcome more heavily in females than in males. Females are likely to exhibit worse overall survival, and older females are at higher risk of post-MI HF.
Identifiants
pubmed: 30976655
doi: 10.1016/j.ijcha.2019.100350
pii: S2352-9067(18)30143-X
pii: 100350
pmc: PMC6441739
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100350Références
Echocardiography. 2003 Nov;20(8):691-701
pubmed: 14641373
Ital Heart J. 2004 Jul;5(7):498-504
pubmed: 15487266
J Am Coll Cardiol. 2005 Mar 15;45(6):832-7
pubmed: 15766815
Am J Physiol Heart Circ Physiol. 2006 May;290(5):H2043-50
pubmed: 16361364
Circulation. 2008 Dec 16;118(25):2803-10
pubmed: 19064680
J Am Coll Cardiol. 2010 Mar 16;55(11):1057-65
pubmed: 20223363
Circulation. 2011 May 10;123(18):2006-13; discussion 2014
pubmed: 21555723
Circ J. 2013;77(7):1646-52
pubmed: 23803294
Rev Esp Cardiol (Engl Ed). 2013 Jun;66(6):472-81
pubmed: 24776050
Arq Bras Cardiol. 2014 Aug;103(2):124-30
pubmed: 25098374
J Am Heart Assoc. 2014 Aug 11;3(4):null
pubmed: 25112555
Eur J Clin Invest. 2014 Oct;44(10):902-9
pubmed: 25175007
J Am Soc Echocardiogr. 2015 Jan;28(1):1-39.e14
pubmed: 25559473
Medicine (Baltimore). 2015 Sep;94(35):e1401
pubmed: 26334894
JACC Cardiovasc Imaging. 2016 Apr;9(4):451-64
pubmed: 27056164
Eur J Prev Cardiol. 2018 Jan;25(2):181-189
pubmed: 29164916
Eur Heart J Qual Care Clin Outcomes. 2015 Nov 1;1(2):72-78
pubmed: 29474597
Med J Aust. 2018 Aug 6;209(3):118-123
pubmed: 30025513