Gender Disparities in St-Elevation Myocardial Infarction Care and Outcomes in Emerging Countries: A Global Lumen Organization for Women (Glow) Initiative and Call to Action

Lee, Hyon Jae; Lansky, Alexandra J.; Mehta, Sameer; Haimi, Ido; Salwan, Roopa; Zambahari, Robaayah; Chen, Yundai; Hassan, Faisal; Parise, Helen; Fasila, Malik; Kontsevaya, A. V.; Cheem, Tan Huay; Baumbach, Andreas; Granger, Christopher B.; Grines, Cindy L.; Jacobs, Alice K.; Tresukosol, Damras; Soerianata, Sunarya; Dy, Timothy C.

doi:10.1016/s0735-1097(16)32357-9

Cited by 7 publications

(3 citation statements)

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“…[18,19] Other studies focusing on STEMI with gender differences have also shown this phenomenon. [20,21] The possible causes include older age and more comorbidities in female patients with ACS. However, a further study on STEMI in younger patients showed worse short-term outcomes in female patients after adjustment for demographics, comorbidities, medications, and severity of coronary disease.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of patients with cardiogenic shock following acute myocardial infarction: The difference between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction

et al. 2022

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Acute myocardial infarction (AMI) complicated by cardiogenic shock has high mortality and remains challenging even in the revascularization era. We conducted this study to understand patients' outcomes. We retrospectively analyzed electronic medical records data from 1175 patients with AMI complicated by cardiogenic shock that developed within 3 days of admission to a multicenter medical care system between January 1, 2000, and July 31, 2018. Patients with AMI were classified into the ST-segment elevation MI (STEMI) group or the non-ST-segment elevation MI (NSTEMI) group. The short-term and 1-year mortality and adverse events after index admission were analyzed via logistic regression and a Cox proportional hazards model. When compared with NSTEMI, patients with STEMI tended to be younger (65.68 ± 14.05 years vs 70.70 ± 12.99 years, P < .001), men (73.29% vs 60.87%, P < .001), and have fewer underlying chronic diseases. Short-term mortality at index hospitalization was 14.83% in the STEMI group and 21.30% in the NSTEMI group; long-term mortality was 17.06% for the STEMI group and 24.13% for the NSTEMI group. No difference was observed between the 2 groups for patients who developed a cerebral vascular accident during the admission period. However, the major and gastrointestinal bleeding rates were higher in the STEMI group (2.66% vs 0.22%, P = .014; 3.36% vs 0.22%, P = .007, respectively). Age and respiratory failure were the most significant risk factors for short-term mortality. Revascularization may be beneficial for the short-term outcome but did not reach significance in multivariable analysis. In patients with AMI with cardiogenic shock, NSTEMI was associated with a significantly higher mortality rate in short-term results.

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Section: Discussionmentioning

confidence: 99%

Prognosis of patients with cardiogenic shock following acute myocardial infarction: The difference between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction

et al. 2022

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“…Multivariate analysis showed that female sex was not an independent risk factor in achieving the primary endpoint. However, many studies have reported a worse long-term prognosis for women after AMI ( 18 ) and a higher 30-day mortality in women than men ( 19 – 21 ). According to the VIRGO analysis (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), women are more likely than men to attribute symptoms of myocardial infarction to stress/anxiety ( 22 ), resulting in delayed initial medical contact and diagnosis ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Does gender affect the outcomes of patients in program of managed care for acute myocardial infarction

Wilkosz

Wita²,

Wybraniec³

et al. 2021

J Rehabil Med

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Background There is increasing evidence that cardiac rehabilitation and regular follow-ups are associated with reduced mortality and morbidity. A programme of Managed Care for Patients with Acute Myocardial Infarction was developed in Poland (MC-AMI; in Polish, KOS-zawał), based on current scientific evidence. However, there is a lack of data on possible improvement in long-term prognosis among women after acute myocardial infarction. Aims To compare the male and female population who participated in MC-AMI, regarding major cardiovascular events, defined as a composite of death, recurrent myocardial infarction, and hospitalization for heart failure, in a 1-year follow-up. Methods A prospective research study from a single cardiology care centre. The study compared 2 groups: women and men who agreed to participate in the MC-AMI programme. Results A total of 529 patients were included in the study (167 women and 362 men). In the 12-month follow-up, the difference in major cardiovascular events events was not statistically significant for women and men, respectively (11.38% women vs 11.33% men; p = 0.98). Cox multivariate regression analysis of the surveyed population showed that coronary heart disease, diabetes mellitus type II, and previous percutaneous coronary intervention were significantly correlated with the primary endpoint. Conclusion Women participating in the MC-AMI programme did not have a worse prognosis regarding major cardiovascular events, compared with men in a 12-month follow-up. Given the benefits of the MCAMI programme, the proportion of women participating in the programme should be increased. LAY ABSTRACT Despite the development of new treatment techniques, myocardial infarction remains one of the leading causes of death in Europe. Women account for 48% of patients with myocardial infarction. Due to clinical, economic, demographic and sociological conditions, the long-term prognosis for women after myocardial infarction is worse than for men. A national programme of managed care after myocardial infarction has been introduced in 2019 year in Poland (MC-AMI; in Polish, KOS-zawał). The programme comprises 4 stages: hospitalization and treatment of the acute phase of myocardial infarction; early cardiological rehabilitation; regular follow-up at in-patient clinic; and evaluation of indications for advanced methods of treatment of post-infarction complications. Implementation of this programme in Poland has resulted in a comparable long-term prognosis being achieved for the male and female population. Widespread use of the MC-AMI programme is a promising option to equalize the prognosis for both sexes after a heart attack.

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“…15,16 Other studies focusing on STEMI with gender difference have also shown this phenomenon. 17,18 The possible causes include older age and more comorbidities in female patients with ACS. However, a further study on STEMI in younger patients showed worse short-term outcomes in female patients after adjustment for demographics, comorbidities, medications, and severity of coronary disease.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of Patients With Cardiogenic Shock Following Acute Myocardial Infarction: The Difference Between ST-Segment Elevation Myocardial Infarction And Non-ST-Segment Elevation Myocardial Infarction

Tsai¹,

Hsieh²,

Chen³

et al. 2021

Preprint

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Background: Acute myocardial infarction (AMI) complicated with cardiogenic shock has high mortality and is a challenging topic even in the revascularization era. We conducted this study to understand patients’ outcomes.Method: We retrospectively analyzed electronic medical records data from 1,175 patients with AMI complicated with cardiogenic shock developed within 3 days of admission to a multicenter medical care system between January 1, 2000, and July 31, 2018. AMI patients were classified into ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) group. The short-term and 1-year mortality and adverse event after the index admission were analyzed via logistic regression and Cox proportional hazards model. Results: Comparing to NSTEMI, patients with STEMI tended to be younger (65.68 ± 14.05 vs. 70.70 ± 12.99, p < .001), men (73.29 vs. 60.87, p < .001), and have fewer underlying chronic diseases. Short-term mortality at index hospitalization was 14.83% in the STEMI group and 21.30% in the NSTEMI group; long-term mortality was 17.06% for the STEMI group and 24.13% for the NSTEMI group. No difference was observed between the 2 groups for patients who developed a cerebral vascular accident (CVA) during the admission period; however, the major bleeding rate and gastrointestinal bleeding rate were higher in the STEMI group (2.66 vs. 0.22, p = .014; 3.36 vs. 0.22, p = .007, respectively). Conclusion: In patients with AMI with cardiogenic shock, NSTEMI was associated with a significantly higher mortality rate in both the short-and long-term results. Age and respiratory failure were the most significant risk factors for short-term mortality. Revascularization may be beneficial for the short-term outcome but did not reach significance in multivariable analysis.

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Gender Disparities in St-Elevation Myocardial Infarction Care and Outcomes in Emerging Countries: A Global Lumen Organization for Women (Glow) Initiative and Call to Action

Cited by 7 publications

References 0 publications

Prognosis of patients with cardiogenic shock following acute myocardial infarction: The difference between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction

Prognosis of patients with cardiogenic shock following acute myocardial infarction: The difference between ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction

Does gender affect the outcomes of patients in program of managed care for acute myocardial infarction

Prognosis of Patients With Cardiogenic Shock Following Acute Myocardial Infarction: The Difference Between ST-Segment Elevation Myocardial Infarction And Non-ST-Segment Elevation Myocardial Infarction

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