Young Women With Acute Myocardial Infarction

Dreyer, Rachel P.; Sciria, Christopher; Spatz, Erica S.; Safdar, Basmah; D’Onofrio, Gail; Krumholz, Harlan M.

doi:10.1161/circoutcomes.116.003480

Cited by 44 publications

(33 citation statements)

References 65 publications

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“…The findings of this original study also contribute to closing the gaps in knowledge of the cardiovascular risk factor profile and short-term prognosis for young women with STEMI. 2,29 Although being diagnosed in approximately 1% of all patients with myocardial infarction, 18,19 spontaneous coronary artery dissection is more frequently encountered in young women. The 22% (95% confidence interval [CI], 11-35%) prevalence of spontaneous coronary artery dissection in women with STEMI observed in our study was consistent with contemporary estimates (24-35%).…”

Section: Discussionmentioning

confidence: 99%

Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45

Vautrin

Jean

Fourny

et al. 2019

Cathet Cardio Intervent

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Objective: We aimed to compare baseline characteristics, coronary angiogram findings, and in-hospital outcomes between female and male patients with ST-segment elevation myocardial infarction (STEMI) under the age of 45 years. Background: Although sex differences in risk factor profile have been documented for young patients with STEMI, limited data exist on the prevalence of spontaneous coronary artery dissection in these patients. Methods: As part of an ongoing hospital-based registry of suspected STEMI, we analyzed the original data for 51 women under the age of 45 years matched with 93 men of similar age who underwent coronary angiography at two percutaneous coronary intervention centers, between January 2003 and December 2012. Two interventional cardiologists independently reviewed coronary angiograms for all patients. Results: The mean age for all patients was 39 years (range, 24-44) and the overall prevalence of cigarette smoking, dyslipidemia, hypertension, and diabetes mellitus were 70, 32, 13, and 4%, respectively. Young women were more likely to present with spontaneous coronary artery dissection (22 vs. 3%, p = .003) and more of them experienced reinfarction during the hospital course (15 vs. 1%, p = .01). The inhospital mortality rate was 2% for both sexes. Conclusions: Spontaneous coronary artery dissection is an important cause of myocardial infarction in young female adults, accounting for 22% (95% confidence interval, 11-35%) of women with STEMI under the age of 45 years. The true prevalence of spontaneous coronary artery dissection might even be underestimated, because of the limited availability of advanced imaging techniques at the time of our study.

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Section: Discussionmentioning

confidence: 99%

Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45

Vautrin

Jean

Fourny

et al. 2019

Cathet Cardio Intervent

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“…For example, in acute coronary syndrome (ACS), the benefits of early invasive strategy resulted less effective in women with high-risk profiles [9,10], exhibiting a higher unadjusted in-hospital mortality in women undergoing PCI [9,10]. So far, only two studies, the BVariation in Recovery: Role of Gender on Outcomes of Young AMI Patients^ [11] and BGENdEr and Sex determInantS of cardiovascular disease: From bench to beyond-Premature Acute Coronary Syndrome^ [12,13], have explored the multilevel interactions between sex and gender in influencing CVD development and management in young patients with ACS [14].…”

Section: Rationalementioning

confidence: 99%

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Raparelli

Proietti

Lenzi

et al. 2018

J. of Cardiovasc. Trans. Res.

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Improvements in ischemic heart disease (IHD) management have been unbalanced between sexes, with coronary microvascular dysfunction considered the likely underlying reason. The Endocrine Vascular disease Approach (EVA) is an observational study (Clinicaltrial.gov NCT02737982) aiming to assess sex and gender interactions between coronary circulation, sexual hormones, and platelet function. Consecutive patients with IHD undergoing coronary angiography will be recruited: (1) to assess sex and gender differences in angiographic reperfusion indexes; (2) to evaluate the effects of estrogen/androgen on sex-related differences in myocardial ischemia; (3) to investigate the platelet biology differences between men and women with IHD; (4) to verify sexand gender-driven interplay between response to percutaneous coronary intervention, platelets, sex hormones, and myocardial damage at baseline and its impact on 12-month outcomes. The integration of sex and gender in this translational project on IHD will contribute to the identification of new targets for further innovative clinical interventions. Keywords Sex. Gender. Coronary microvascular dysfunction. Sex steroid hormones. Platelet function. Clinical outcomes. Myocardial blush grade Abbreviations 1VD One-vessel disease 2VD Two-vessel disease 3VD Three-vessel disease ACS Acute coronary syndrome AR Androgen receptors CAD Coronary artery disease CMD Coronary microvascular dysfunction CMR Cardiac magnetic resonance CVD Cardiovascular disease E2 Estradiol eCRFs Electronic case report forms ER Estrogen receptor GP Glycoprotein IHD Ischemic heart disease INOCA Ischemia and no obstructive CAD MACE Major adverse cardiovascular events MBG Myocardial blush grade MMAS-4 Morisky Medication Adherence Scale-4 Items NOS Nitric oxide synthase NOX2 NADPH oxidase 2 NSTEMI Non-ST elevation myocardial infarction PCI Percutaneous coronary intervention STEMI ST elevation myocardial infarction (c)TFC (corrected) TIMI frame count Associate Editor Enrique Lara-Pezzi oversaw the review of this article

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“…Yet the ability to reflect on the past and then use it as a lens toward the future has always been essential to scientific endeavors, and it is a model followed by several papers we've published in the past. 1,2 That is the gap we hope these papers will continue to fill.…”

mentioning

confidence: 99%

Frontiers in Cardiovascular Outcomes Research

Nallamothu

2018

Circ: Cardiovascular Quality and Outcomes

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Young Women With Acute Myocardial Infarction

Cited by 44 publications

References 65 publications

Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45

Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45

Sex and Gender Differences in Ischemic Heart Disease: Endocrine Vascular Disease Approach (EVA) Study Design

Frontiers in Cardiovascular Outcomes Research

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