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The contribution of gender and age on early and late mortality following ST-segment elevation myocardial infarction: results from the Korean acute myocardial infarction national registry

Session Poster Session 7

Speaker Ae-Young Her

Event : ESC Congress 2018

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease: Treatment, Revascularization
  • Session type : Poster Session

Authors : A-Y Her (Chuncheon,KR), E-S Shin (Ulsan,KR), YH Kim (Chuncheon,KR)

Authors:
A.-Y. Her1 , E.-S. Shin2 , Y.H. Kim1 , 1Kangwon National University Hospital, Department of Internal Medicine, Division of Cardiology - Chuncheon - Korea Republic of , 2Ulsan University Hospital - Ulsan - Korea Republic of ,

Citation:
European Heart Journal ( 2018 ) 39 ( Supplement ), 1362

Background: Although previous studies using Korean data have already reported higher rates of mortality in women, it is less clear whether these gender differences in prognosis post ST-segment elevation myocardial infarction (STEMI), are age dependent.

Purpose: The aim of this study is to examine the gender-age interaction with early and late mortality in patients with STEMI enrolled in the Korean nationwide registry.

Methods: This prospective study stratified outcomes according to gender and age from 17,021 STEMI patients. We compared in-hospital, early (30 days) and late (12 months) mortality between gender to examine the gender-age interaction in multivariable models.

Results: In younger women (<60 years), in-hospital (5.8% vs. 2.5%, p<0.001; unadjusted OR 2.41, 95% CI 1.59 to 3.66), early (6.2% vs. 2.6%, p<0.001; unadjusted OR 2.4, 95% CI 2.12 to 2.72) and late mortality (7.0% vs. 3.1%, p>0.001; unadjusted OR 2.33, 95% CI 2.08 to 2.61) were significantly higher compared with men. However, after adjustment for patient characteristics, Killip class ≥3, symptom to balloon time and major bleeding, and in-hospital bleeding, overall early and late mortality were no longer related to gender in any age groups.

Conclusions: Among a Korean population with STEMI, higher early and late mortality in younger women may be explained by poor patient characteristics, higher Killip class ≥3, longer symptom to balloon time and more frequent major bleeding. More intensive treatment strategies based on gender-age differences are needed in these patients.

Major adverse cardiovascular events (MACEs) between men and women
All patientsAge group, year
MenWomenp-value<6060–6970–79≥80
n=12562n=4459n=7079n=4050n=4203n=1689
12 months FUOR*
All cause death774 (7.1)576 (15.2)<0.0012.361.311.331.01
Cardiac death566 (5.2)436 (11.5)<0.0012.102.751.441.00
Non-cardiac death208 (1.9)140 (3.7)<0.0012.840.961.031.03
Recurrent myocardial infarction49 (0.5)23 (0.6)0.2420.830.474.191.14
Repeat revascularization234 (2.2)65 (1.7)0.0960.621.010.870.98
MACEs1057 (9.8)664 (17.5)<0.0011.551.221.311.01

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