Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis

Lorca, Rebeca; Pascual, Isaac; Aparicio, Andrea; Junco-Vicente, Alejandro; Álvarez-Velasco, Rut; Barja, Noemí; Roces, Luis; Suárez-Cuervo, Alfonso; Díaz, Rocío; Morís, César; Hernández-Vaquero, Daniel; Avanzas, Pablo

doi:10.3390/jcm10061314

Cited by 5 publications

(3 citation statements)

References 39 publications

(52 reference statements)

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“…Conversely, men are rarely affected [ 11 , 12 ]. In these populations, the prevalence of SCAD can reach as high as 45.0% and 43%, respectively [ 13 , 14 , 15 , 16 , 17 , 18 ].…”

Section: Coronary Artery Dissection — a Review Of The Literaturementioning

confidence: 99%

Chest Pain: Wellens Syndrome Due to Spontaneous Dissection of the Left Anterior Descending Coronary Artery — A Case Report and Literature Review

Clemente,

Quaranta,

Basso

et al. 2024

Rev. Cardiovasc. Med.

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Wellens syndrome is an abnormal electrocardiographic pattern characterized by biphasic (type A) or deeply inverted (type B) T waves in leads V2–V3. It is typically caused by temporary obstruction of the left anterior descending (LAD) coronary artery due to the rupture of an atherosclerotic plaque leading to occlusion. Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and even a rarer cause of Wellens Syndrome. It occurs when an intramural hematoma forms, leading to the separation of the tunica intima from the outer layers and creating a false lumen that protrudes into the real lumen, ultimately reducing blood flow and thus resulting in myocardial infarction. Here we report a case of SCAD presenting as an acute coronary syndrome with self-resolving chest pain, slightly elevated myocardial necrosis markers and electrocardiographic changes consistent with Wellens pattern type A first, and type B afterwards, that were not present upon arrival to the emergency department.

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“…Conversely, men are rarely affected [ 11 , 12 ]. In these populations, the prevalence of SCAD can reach as high as 45.0% and 43%, respectively [ 13 , 14 , 15 , 16 , 17 , 18 ].…”

Section: Coronary Artery Dissection — a Review Of The Literaturementioning

confidence: 99%

Chest Pain: Wellens Syndrome Due to Spontaneous Dissection of the Left Anterior Descending Coronary Artery — A Case Report and Literature Review

Clemente,

Quaranta,

Basso

et al. 2024

Rev. Cardiovasc. Med.

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“…Information on the MINOCA was imperfect in the KAMIR-NIH registry. Specifically, we did not have data on some aetiologies of MINOCA, such as spontaneous coronary artery dissection [24,25]. Finally, the results of our analysis should be tested in other validation cohorts, especially Western patients.…”

Section: Study Limitationsmentioning

confidence: 99%

Gender Differences in All-Cause Mortality after Acute Myocardial Infarction: Evidence for a Gender–Age Interaction

Song

Kim

Seong

et al. 2022

JCM

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Gender difference studies in mortality after acute myocardial infarction (AMI) have shown inconsistent results. A total of 13,104 patients from the KAMIR-NIH between November 2011 and December 2015 were classified into young (n = 3837 [29.3%]) and elderly (n = 9267 [70.7%]) patients. For the study, women <65 and men <55 years of age were considered “young”. In the adjusted model of the entire cohort, there was no significant difference in three-year all-cause mortality between women and men (17.8% vs. 10.3%; adjusted hazard ratio [HR], 0.953; 95% confidence interval [CI], 0.799–1.137). However, when the entire cohort was subdivided into two age groups, young women showed an 84.3% higher mortality rate than young men (adjusted HR, 1.843; 95% CI, 1.098–3.095). Contrariwise, elderly women patients had a 20.4% lower hazard of mortality compared with elderly men (adjusted HR, 0.796; 95% CI, 0.682–0.929). The interaction of gender with age was significant, even after multiple adjustments (adjusted p for interaction = 0.003). The purpose of this study was to assess whether gender differences depend on the patients’ age. Based on our analysis, higher mortality of young women remains even in the contemporary era of AMI. A better understanding of the mechanisms underlying these differences is warranted.

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“…Given that young individuals have a longer life expectancy and higher demands on the quality of life, conducting in-depth studies on this group's clinical and prognostic indicators is essential. A few studies give us some clue on the prevalence, characteristics, and prognosis of premature AMI in Europe and the Americas area (6)(7)(8)(9)(10)(11)(12). The present study provides evidence on risk factors, clinical features, and in-hospital and mid-to-long-term prognosis of premature AMI in China.…”

Section: Introductionmentioning

confidence: 99%

Risk factors, clinical features, and outcomes of premature acute myocardial infarction

Liu

Shi

Zhang

et al. 2022

Front. Cardiovasc. Med.

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AimsTo investigate the risk factors, clinical features, and prognostic factors of patients with premature acute myocardial infarction (AMI).Materials and methodsA retrospective cohort study of patients with AMI included in data from the West China Hospital of Sichuan University from 2011 to 2019 was divided into premature AMI (aged < 55 years in men and < 65 years in women) and non-premature AMI. Patients’ demographics, laboratory tests, Electrocardiography (ECG), cardiac ultrasound, and coronary angiography reports were collected. All-cause death after incident premature MI was enumerated as the primary endpoint.ResultsAmong all 8,942 AMI cases, 2,513 were premature AMI (79.8% men). Compared to the non-premature AMI group, risk factors such as smoking, dyslipidemia, overweight, obesity, and a family history of coronary heart disease (CHD) were more prevalent in the premature AMI group. The cumulative survival rate of patients in the premature AMI group was significantly better than the non-premature AMI group during a mean follow-up of 4.6 years (HR = 0.27, 95% CI 0.22–0.32, p < 0.001). Low left ventricular ejection fraction (LVEF) (Adjusted HR 3.00, 95% CI 1.85–4.88, P < 0.001), peak N-terminal pro-B-type natriuretic peptide (NT-proBNP) level (Adjusted HR 1.34, 95% CI 1.18–1.52, P < 0.001) and the occurrence of in-hospital major adverse cardiovascular and cerebrovascular events (MACCEs) (Adjusted HR 2.36, 95% CI 1.45–3.85, P = 0.001) were predictors of poor prognosis in premature AMI patients.ConclusionAMI in young patients is associated with unhealthy lifestyles such as smoking, dyslipidemia, and obesity. Low LVEF, elevated NT-proBNP peak level, and the occurrence of in-hospital MACCEs were predictors of poor prognosis in premature AMI patients.

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Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis

Cited by 5 publications

References 39 publications

Chest Pain: Wellens Syndrome Due to Spontaneous Dissection of the Left Anterior Descending Coronary Artery — A Case Report and Literature Review

Chest Pain: Wellens Syndrome Due to Spontaneous Dissection of the Left Anterior Descending Coronary Artery — A Case Report and Literature Review

Gender Differences in All-Cause Mortality after Acute Myocardial Infarction: Evidence for a Gender–Age Interaction

Risk factors, clinical features, and outcomes of premature acute myocardial infarction

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