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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:
YH Kim1 , A-Y Her1 , MH 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 - 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) ,

Citation:

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.

Cumulative Events at 2-year (%)

Unadjusted

Adjusted*

Propensity-score adjusted

Outcomes

Male

Female

Log-rank

Hazard Ratio (95% CI)

p value

Hazard Ratio (95% CI)

p value

Hazard Ratio (95% CI)

p value

MACE

819 (7.2)

78 (10.0)

0.003

1.419 (1.125 - 1.790)

0.003

1.047 (0.756 - 1.450)

0.782

1.133 (0.871 - 1.473)

0.352

All-cause death

283 (2.5)

38 (4.8)

<0.001

1.988 (1.417 - 2.789)

<0.001

0.764 (0.457 - 1.279)

0.306

1.105 (0.744 - 1.641)

0.620

Cardiac death

224 (1.9)

25 (3.2)

0.016

1.654 (1.094 - 2.500)

0.017

0.512 (0.261 - 1.005)

0.052

0.822 (0.511 - 1.322)

0.419

Re-MI

142 (1.3)

18 (2.4)

0.010

1.885 (1.154 - 3.078)

0.011

1.741 (0.887 - 3.419)

0.107

1.835 (1.109 - 3.375)

0.062

Total revascularization

444 (4.0)

27 (3.6)

0.594

0.900 (0.610 - 1.327)

0.594

1.069 (0.654 - 1.748)

0.789

0.956 (0.627 - 1.458)

0.835

TLR

121 (1.1)

8 (1.1)

0.956

0.980 (0.479 - 2.004)

0.956

0.955 (0.366 - 2.497)

0.926

0.868 (0.395 - 1.910)

0.726

TVR

228 (2.1)

14 (1.9)

0.726

0.908 (0.529 - 1.558)

0.726

1.051 (0.518 - 2.135)

0.890

0.935 (0.519 - 1.684)

0.823

Non-TVR

223 (2.0)

13 (1.7)

0.602

0.862 (0.493 - 1.508)

0.602

1.060 (0.536 - 2.097)

0.867

0.942 (0.514 - 1.726)

0.847

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