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Current smoking and gender difference in South Korean AMI patients who underwent PCI with DES

Session Poster Session 5

Speaker Ae-Young Her

Event : ESC Congress 2019

  • Topic : preventive cardiology
  • Sub-topic : Tobacco
  • Session type : Poster Session

Authors : YH Kim (Chuncheon,KR), A-Y Her (Chuncheon,KR), MH Jeong (Gwangju,KR), B-K Kim (Seoul,KR), S-Y Lee (Gunpo,KR), S-J Hong (Seoul,KR), D-H Shin (Seoul,KR), C-M Ahn (Seoul,KR), J-S Kim (Seoul,KR), Y-G Ko (Seoul,KR), D Choi (Seoul,KR), M-K Hong (Seoul,KR), Y Jang (Seoul,KR)

Authors:
Y.H. Kim1 , A.-Y. Her1 , M.H. Jeong2 , B.-K. Kim3 , S.-Y. Lee4 , S.-J. Hong3 , D.-H. Shin3 , C.-M. Ahn3 , J.-S. Kim3 , Y.-G. Ko3 , D. Choi3 , M.-K. Hong3 , Y. Jang3 , 1Kangwon National University School of Medicine - Chuncheon City - Korea (Republic of) , 2Chonnam National University Hospital, Department of Cardiology - Gwangju - Korea (Republic of) , 3Severance Cardiovascular Hospital, Division of Cardiology, Yonsei University College of Medicine - Seoul - Korea (Republic of) , 4Sanbon Hospital, Wonkwang University College of Medicine, Department of Cardiology - Gunpo - Korea (Republic of) ,

Topic(s):
Tobacco

Citation:
European Heart Journal ( 2019 ) 40 ( Supplement ), 2626

Background: There is some debate on whether or not there is a gender difference is present between current smoking and cardiovascular disease.

Purpose: We decide to evaluate the impact of sex difference on the 2-year clinical outcomes in Korean acute myocardial infarction (AMI) patients who currently smoke and who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES).

Methods: The data of this study was obtained from the Korea Acute Myocardial Infarction (KAMIR) registry. More than fifty high-volume universites or community hospitals with facilities for primary PCI and onsite cardiac surgery participated in this KAMIR registry. A total of 12565 current smoker AMI patients were enrolled and divided into the male (n=11767, 93.6%) or female (n=798, 6.4%) group. The clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), and total repeat revascularization.

Results: Before risk adjustment, the cumulative incidences of MACE (7.2% vs. 10.0%, hazard ratio [HR], 1.419; 95% confidence interval [CI], 1.125–1.790; P=0.003), all-cause death (HR, 1.988; 95% CI, 1.417–2.789; P<0.001), and re-MI (HR, 1.885; 95% CI, 1.154–3.078; P=0.011) were significantly higher in the female group compared with the male group. However, after adjustment the cumulative incidences of MACE (adjusted HR, 1.047; 95% CI, 0.756–1.450; P=0.782), all-cause death, re-MI, total repeat revascularization, TLR, TVR, and non-TVR were similar between the two groups.

Conclusion: Before risk adjustment, a gender difference was suggested in the female group compared with the male in these current smoker South Korean AMI patients during a 2-year follow-up period. However, after adjustment, gender difference was not observed in these AMI patients with a history of current smoking.

Clinical outcomes at 2-year
OutcomesCumulative Events at 2-year (%)UnadjustedAdjusted*Propensity-score adjusted
MaleFemaleLog-rankHazard Ratio (95% CI)p valueHazard Ratio (95% CI)p valueHazard Ratio (95% CI)p value
MACE819 (7.2)78 (10.0)0.0031.419 (1.125–1.790)0.0031.047 (0.756–1.450)0.7821.133 (0.871–1.473)0.352
All-cause death283 (2.5)38 (4.8)<0.0011.988 (1.417–2.789)<0.0010.764 (0.457–1.279)0.3061.105 (0.744–1.641)0.620
Cardiac death224 (1.9)25 (3.2)0.0161.654 (1.094–2.500)0.0170.512 (0.261–1.005)0.0520.822 (0.511–1.322)0.419
Re-MI142 (1.3)18 (2.4)0.0101.885 (1.154–3.078)0.0111.741 (0.887–3.419)0.1071.835 (1.109–3.375)0.062
Total revascularization444 (4.0)27 (3.6)0.5940.900 (0.610–1.327)0.5941.069 (0.654–1.748)0.7890.956 (0.627–1.458)0.835
TLR121 (1.1)8 (1.1)0.9560.980 (0.479–2.004)0.9560.955 (0.366–2.497)0.9260.868 (0.395–1.910)0.726
TVR228 (2.1)14 (1.9)0.7260.908 (0.529–1.558)0.7261.051 (0.518–2.135)0.8900.935 (0.519–1.684)0.823
Non-TVR223 (2.0)13 (1.7)0.6020.862 (0.493–1.508)0.6021.060 (0.536–2.097)0.8670.942 (0.514–1.726)0.847

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