Evolution of ST-Elevation Acute Myocardial Infarction Prevalence by Gender Assessed Age Pyramid Analysis—The Piramyd Study

Loyeau, Aurélie; Benamer, Hakim; Bataille, Sophie; Tepper, Sarah; Boche, Thévy; Lamhaut, Lionel; Pires, Vanda; Benoit, Sandrine; Dupas, François; Weisslinger, Lisa; Bail, Gaëlle Le; Allonneau, Alexandre; Juliard, Jean‐Michel; Lambert, Yves; Lapostolle, Frédéric

doi:10.3390/jcm7120509

Cited by 10 publications

(6 citation statements)

References 28 publications

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“…In numerous studies, the interaction between gender, risk factors and incidence of myocardial infarction remains controversial 13 . Some studies have suggested specific gender‐intrinsic‐causes even after adjustment for age and other risk factors, 2,8,14 while others have failed to establish an association between gender and mortality 15,16,17 …”

Section: Introductionmentioning

confidence: 99%

Gender differences in acute myocardial infarction—A nationwide German real‐life analysis from 2014 to 2017

Kuehnemund

Köppe²,

Feld³

et al. 2021

Clinical Cardiology

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Background Female sex was reported to be associated with an unfavorable outcome in acute myocardial infarction (AMI). In this nationwide analysis we assessed sex differences in acute outcomes of AMI and recent trends in patient healthcare. Methods We analyzed 875 735 German cases hospitalized with a main diagnosis of ST‐ (STEMI) and non ST‐elevation myocardial infarction (NSTEMI) between January 01 2014 and December 31 2017 regarding morbidity, in‐hospital mortality and treatments. A multivariable logistic regression model was designed to evaluate the use of interventions and their impact on in‐hospital mortality. Results STEMI cases decreased from 72 894 in 2014 to 68 213 in 2017, with 70% assignable to men. Female sex was associated with older age (74 vs. 62 years), and higher prevalence of cardiovascular risk factors such as chronic kidney disease (19.2% vs. 12.5%), hypertension (69.0% vs. 65.0%) and left ventricular heart failure (36.0% vs. 32.1%). In NSTEMI, female sex was also associated with older age (78 vs. 71 years), and higher prevalence of cardiovascular risk factors such as chronic kidney disease (29.7% vs. 23.9%), hypertension (77.4% vs. 74.5%) and left ventricular heart failure (40.5% vs. 36.4%). Overall, 74.3% of female and 81.3% of male STEMI cases received percutaneous coronary intervention (PCI, p < 0.001). In NSTEMI, PCI was performed in 40.8% of female and 52.0% of male cases (p < 0.001). In‐hospital mortality was notably increased in female patients with STEMI (15.0% vs. 9.6%; p < 0.001; OR 1.07; 95% CI 1.03–1.10) and NSTEMI (8.3% vs. 6.3%; p < 0.001; OR 0.91; 95% CI 0.89–0.93) compared to males. Conclusions Our nationwide real‐world data document that in‐patient STEMI cases continue to decrease in women and men. The observed higher in‐hospital mortality in women was largely attributed to a more unfavorable risk and age distribution rather than to female‐intrinsic factors. Women with AMI continue to be less likely to receive revascularization therapies.

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Section: Introductionmentioning

confidence: 99%

Gender differences in acute myocardial infarction—A nationwide German real‐life analysis from 2014 to 2017

Kuehnemund

Köppe²,

Feld³

et al. 2021

Clinical Cardiology

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“…These results could denote that, in Mexico, the preventive measures are not enough to moderate the incidence of STEMI and that there are factors that could be conditioning to a more severe form of heart attack. This unfavourable evolution in our country is in line with the increase in the prevalence of cardiovascular risk factors such as hypertension, smoking, T2DM, and dyslipidaemia, among others, and this trend is contrary to the decrease in STEMI cases reported in countries such as the United States and Europe [ 10 ].…”

Section: Discussionmentioning

confidence: 88%

Good Practices in the Clinical Management of Patients with Acute Coronary Syndrome: Retrospective Analysis in a Third-Level Hospital in Mexico

Flores-Salinas

Casillas-Muñoz

Valle

et al. 2020

Cardiology Research and Practice

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Introduction and Objective. In Mexico, there has been an increase in the risk of cardiovascular disease due to rising life expectancy, westernized lifestyle, lack of prevention, and industrialized exposure. This article describes the pharmacological treatment, surgical interventions, and associated clinical complications in patients diagnosed with acute coronary syndrome (ACS) and their impact on in-hospital mortality frequency in a Cardiology Unit in Instituto Mexicano del Seguro Social. Methods. This is a retrospective study including male and female patients aged ≥18 years who were diagnosed with ACS. The collected data included demographic characteristics, risk factors, medications, electrocardiograms, surgical procedures, and in-hospital deaths. Results. There are at least 20% more diagnoses of ST-segment elevation myocardial infarction in this hospital compared to the latest national reports in Mexico. The most common risk factors were type 2 diabetes mellitus, hypertension, smoking, and dyslipidaemia. Diabetic patients with a clinical history of percutaneous coronary intervention had a higher risk of non-ST-segment elevation myocardial infarction than nondiabetics (OR: 2.34; p=0.013), also smoking patients with previous heart surgery than nonsmokers (OR: 7.73; p=0.0007). The average in-hospital mortality was 3.6% for ACS. Conclusions. There is a higher percentage of coronary interventionism and improvement in pharmacological treatment, which is reflected in lower mortality. The substantial burden of T2DM could be related to a higher number of cases of STEMI. Diabetics with precedent percutaneous coronary intervention and smokers with previous heart surgery have an increased risk of subsequent infarction.

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“…The same phenomenon has been suggested in women [ 31 ]. Women are becoming more numerous in the older age groups in accordance with the demographics of the populations in France and most Western countries [ 32 , 33 ]. The evolution of the prevalence of cardiovascular risk factors is consistent with the age groups [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Evolution of REperfusion Strategies and impact on mortality in Old and Very OLD STEMI patients. The RESOVOLD-e-MUST study

Lapostolle,

Petrovic,

Moiteaux

et al. 2024

Age and Ageing

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Background The use of myocardial reperfusion—mainly via angioplasty—has increased in our region to over 95%. We wondered whether old and very old patients have benefited from this development. Methods Setting: Greater Paris Area (Ile-de-France). Data Regional registry, prospective, including since 2003, data from 39 mobile intensive care units performing prehospital treatment of patients with ST segment elevation myocardial infarction (STEMI) (<24 h). Parameters Demographic, decision to perform reperfusion and outcome (in-hospital mortality). Primary endpoint Reperfusion decision rate by decade over age 70. Secondary endpoint Outcome. Results We analysed the prehospital management of 27,294 patients. There were 21,311 (78%) men and 5,919 (22%) women with a median age of 61 (52–73 years). Among these patients, 8,138 (30%) were > 70 years, 3,784 (14%) > 80 years and 672 (2%) > 90 years. The reperfusion decision rate was 94%. It decreased significantly with age: 93, 90 and 76% in patients in their seventh, eighth and ninth decade, respectively. The reperfusion decision rate increased significantly over time. It increased in all age groups, especially the higher ones. Mortality was 6%. It increased significantly with age: 8, 16 and 25% in patients in their seventh, eighth and ninth decade, respectively. It significantly decreased over time in all age groups. The odds ratio of the impact of reperfusion decision on mortality reached 0.42 (0.26–0.68) in patients over 90 years. Conclusion the increase in the reperfusion decision rate was the greatest in the oldest patients. It reduced mortality even in patients over 90 years of age.

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Evolution of ST-Elevation Acute Myocardial Infarction Prevalence by Gender Assessed Age Pyramid Analysis—The Piramyd Study

Cited by 10 publications

References 28 publications

Gender differences in acute myocardial infarction—A nationwide German real‐life analysis from 2014 to 2017

Gender differences in acute myocardial infarction—A nationwide German real‐life analysis from 2014 to 2017

Good Practices in the Clinical Management of Patients with Acute Coronary Syndrome: Retrospective Analysis in a Third-Level Hospital in Mexico

Evolution of REperfusion Strategies and impact on mortality in Old and Very OLD STEMI patients. The RESOVOLD-e-MUST study

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