Sex disparities in acute myocardial infarction care and outcomes

Gul, Burcu; Kozuma, Ken; Haimi, Ido; Zhao, Weiying; Simonton, Charles A.; Shen, Ying; Buda, Alexandra; Mehta, Sameer; Baumbach, Andreas; Lansky, Alexandra J.

doi:10.1002/ccd.27622

Cited by 6 publications

(8 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also found an increased rate of MACE events in women. These results are similar to those of other recent studies, which show higher incidence of MACE in women than in men, mainly due to poorer cardiovascular risk factor profile and older age [ 30 ], but also due to increased bleeding risk [ 31 ]. Overall, mortality rates were higher in our study compared to those reported in Western Europe.…”

Section: Discussionsupporting

confidence: 92%

Impact of Three-Dimensional Strain on Major Adverse Cardiovascular Events after Acute Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention—A Pilot Study

Tomoaia

Beyer²,

Zdrenghea

et al. 2021

Life

View full text Add to dashboard Cite

Background: Three-dimensional speckle-tracking echocardiography (3D-STE) allows simultaneous assessment of multidirectional components of strain. However, there are few data on its usefulness to predict prognosis in patients with acute myocardial infarction (AMI). The objective of our pilot study was to evaluate the prognostic value of four different 3D-STE parameters (global longitudinal strain (GLS-3D), global circumferential strain (GCS-3D), global radial strain (GRS-3D), and global area strain (GAS)) in AMI, after successful revascularization by primary PCI. Methods: We enrolled 94 AMI patients (66 ± 13 years, 56% men) who underwent coronary angiography. All patients had been 3D-STE assessed and followed-up for 1 year for the occurrence of MACE. Results: A total of 25 MACE were recorded over follow-up. Cut-off values of −17% for GAS (HR = 3.1, 95% CI: 1.39–6.92, p = 0.005), −12% for GCS-3D (HR = 3.06, 95% CI: 1.36–6.8, p = 0.006), −10% for GLS-3D (HR = 3.04, 95% CI: 1.36–6.78, p = 0.006), and 25% for GRS-3D (HR = 2.89, 95% CI: 1.29–6.46, p = 0.009) showed moderate accuracy in MACE prediction. Multivariate regression showed that GAS (HR = 1.1, 95% CI: 1.03–1.16), GLS-3D (HR = 1.13, 95% CI: 1.03–1.26), and GCS-3D (HR = 1.13, 95% CI: 1.03–1.23) remained independent predictors of MACE (HR = 1.07, 95% CI: 1.01–1.14 for GAS, and HR = 1.1, 95% CI: 1.01–1.2 for GCS-3D). However, post hoc power analysis indicated adequate sample size (power of 80%) only for GAS and GCS-3D for the ROC curve analysis and for GAS, GCS-3D, and GRS-3D for the log-rank test. Conclusion: Patients with AMI might benefit from early risk stratification with the aid of 3D-STE measurements, particularly GAS and GCS-3D, but larger studies are necessary to determine the optimal cut-off values to predict MACE.

show abstract

Section: Discussionsupporting

confidence: 92%

Impact of Three-Dimensional Strain on Major Adverse Cardiovascular Events after Acute Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention—A Pilot Study

Tomoaia

Beyer²,

Zdrenghea

et al. 2021

Life

View full text Add to dashboard Cite

show abstract

“…Cardiovascular disease is the leading cause of death in women . Following percutaneous coronary intervention (PCI), women suffer disproportionately high rates of death, bleeding and complications including myocardial infarction (MI) and stroke . Furthermore, female gender is an independent predictor of death, MI, stent thrombosis and target lesion revascularization after PCI of calcific coronary lesions …”

Section: Introductionmentioning

confidence: 99%

Sex differences in procedural and clinical outcomes following rotational atherectomy

Ford

Khan

Docherty

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

Aim: Evaluate sex differences in procedural net adverse clinical events and long-term outcomes following rotational atherectomy (RA).Methods and Results: From August 2010 to 2016, 765 consecutive patients undergoing RA PCI were followed up for a median of 4.7 years. 285 (37%) of subjects were female. Women were older (mean 76 years vs. 72 years; p < .001) and had more urgent procedures (64.6 vs. 47.3%; p < .001). Females received fewer radial procedures (75.1 vs. 85.1%; p < .001) and less intravascular imaging guidance (16.8 vs. 25.0%; p = .008). After propensity score adjustment, the primary endpoint of net adverse cardiac events (net adverse clinical events: all-cause death, myocardial infarction, stroke, target vessel revascularization plus any procedural complication) occurred more often in female patients (15.1 vs. 9.0%; adjusted OR 1.81 95% CI 1.04-3.13; p = .037). This was driven by an increased risk of procedural complications rather than procedural major adverse cardiac events (MACE). Specifically, women were more likely to experience coronary dissection (4.6 vs. 1.3%; p = .008), cardiac tamponade (2.1 vs. 0.4%; p = .046) and significant bleeding (BARC ≥2: 5.3 vs. 2.3). Despite this, overall MACE-free survival was similar between males and females (adjusted HR 1.03; 95% CI 0.80-1.34; p = .81). Procedural complications during RA were associated with almost double the incidence of MACE at long-term follow-up (HR 1.92; 95% CI 1.34-2.77; p < .001).

show abstract

“…There are sex differences in the incidence, pathophysiology, and clinical presentation of heart disease. Women with ischemic heart disease have worse outcomes and are less likely to receive timely treatment than men [ 47 , 48 ]. More women, after menopause, have dyslipidemia than men [ 47 ], which is seen from the results of this study.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Circadian Clock Genes and Myocardial Infarction Susceptibility

Škrlec

Talapko

Juzbašić

et al. 2021

JCDD

View full text Add to dashboard Cite

The growing body of evidence shows a significant difference in the circadian rhythm of cardiovascular disease based on biological sex. The incidence of cardiovascular disease varies between women and men. Additionally, biological sex is vital for the timely application of therapy—chronotherapy, which benefits both sexes. This study aimed to examine the potential difference of single nucleotide polymorphisms (SNPs) of the circadian rhythm genes ARNTL, CLOCK, CRY2 and PER2 in women and men with myocardial infarction. A cross-sectional study was conducted, including 200 patients with myocardial infarction. Altogether, ten single nucleotide polymorphisms in the ARNTL, CLOCK, CRY2 and PER2 genes were analyzed. The Chi-square test yielded statistically significant differences in CLOCK gene rs11932595 polymorphism in a recessive genotype model between women and men with a p-value of 0.03 and an odds ratio 2.66, and a corresponding 95% confidence interval of 1.07 to 6.66. Other analyzed polymorphisms of the circadian rhythm genes ARNTL, CRY2, and PER2 did not significantly differ between the sexes. According to the study’s current results, the CLOCK gene’s genetic variability might affect myocardial infarction concerning biological sex.

show abstract

Sex disparities in acute myocardial infarction care and outcomes

Cited by 6 publications

References 36 publications

Impact of Three-Dimensional Strain on Major Adverse Cardiovascular Events after Acute Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention—A Pilot Study

Impact of Three-Dimensional Strain on Major Adverse Cardiovascular Events after Acute Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention—A Pilot Study

Sex differences in procedural and clinical outcomes following rotational atherectomy

Sex Differences in Circadian Clock Genes and Myocardial Infarction Susceptibility

Contact Info

Product

Resources

About