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Ever since the Framingham study proposed the gender difference in acute myocardial infarction (AMI). Although the impact of gender in AMI is clear, views differ concerning its details. The objective of this study is to compare the impact of gender on long-term outcomes of patients in Japan who have had ST-segment elevation myocardial infarction.
Subjects were 652 patients with ST-segment elevation myocardial infarction who underwent PCI from 2004 to 2009. The study population was divided into females (F group: N=142) and males (M group: N=510), and were compared for lifestyle at time of onset, clinical characteristics, and lesion characteristics. And was divided into elderly patients over 65 years of age (E group) and non-elderly patients under 65 (NE group), and the groups were compared for mortality rate within 30 days and MACE at 1 year.
There were significant difference in history of smoking (F: 23.2% vs.M: 57.5%, p<0.05). The time of onset was highest between 6:00 to 9:00 in the F group (21.2%) and M group (17.9%). Extent of CAD was 1.46 in F group and 1.71 in M group. There was no difference in Killip IV between F (16.3%) and M (12.7%). In QCA, there was no difference in late loss as well (F: 0.98 mm vs. M: 1.02 mm). Comparisons between the F and M groups revealed a significantly higher mortality within 30 days in the F group as opposed to the M group (F: 13.4% vs. M: 6.5%, p<0.05). Incidence of MACE at 1 year was significantly higher in the F group with F group 34.6% and M group 20.5% (p<0.01). The F and M groups were each subdivided into the E and NE groups, and when the four groups were compared, it was revealed that cardiac death within 30 days was significantly higher in the F-E group at 15.1%(p<0.05). The incidence of MACE at 1 year was significantly higher in the F-E group at 37.2%. When multivariate analysis was used to study associations within the F group, body height (OR,0.93; 95% CI, 0.84 to 0.98, p<0.01) was found to be factors influencing MACE.
In Japan, the occurrence of cardiovascular events following STEMI was high in women over 65 years of age. It was suggested that height might be involved in the long-term prognoses of women patients over 65 years of age following STEMI.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Gender, Dissection, Outcomes from ACS
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1170-201
- 2013 American College of Cardiology Foundation