“These women need regular follow-up after a cardiac event, tight control of blood pressure, cholesterol levels and diabetes, and referral to cardiac rehabilitation. Smoking among young women is on the rise, and this should be addressed, along with promoting exercise and healthy lifestyles. .”
Previous studies have shown that women with ST-elevation myocardial infarction (STEMI) have a worse prognosis during hospital stay than men, and this may be due to their older age, increased comorbidity, and less use of stents. percutaneous coronary intervention; PCI) to open blocked arteries.2 This study compared short- and long-term outcomes after STEMI in women and men and examined whether gender differences were evident in both premenopausal (aged 55 and younger) and postmenopausal (over 55) women.
This was a retrospective observational study of consecutive patients with STEMI treated with PCI within 48 hours of symptom onset between 2010 and 2015. Adverse outcomes were defined as 30-day all-cause mortality, 5-year all-cause mortality, and 5-year mortality. – major adverse cardiovascular events (MACE; a composite of all-cause death, infarction, hospitalization for heart failure and ischemic stroke) of the year.
884 patients participated in the study. The average age was 62 years and 27% were women. Women were older than men (mean age 67 vs. 60 years), and had higher blood pressure, diabetes, and previous stroke. Men were more likely to smoke and develop coronary artery disease. Overall, the time between symptoms and PCI treatment did not differ between women and men, but women aged 55 years and younger had a significantly longer delay to treatment after hospital arrival than men (95 vs. 80 minutes).
The researchers compared women’s and men’s risk of adverse outcomes after adjusting for factors that may influence the relationship, including diabetes, high cholesterol, hypertension, coronary artery disease, heart failure, chronic kidney disease, peripheral artery disease, stroke, and a family history of coronary artery disease. arterial disease. At 30 days, 11.8% of women had died compared with 4.6% of men, for a hazard ratio (HR) of 2.76. After five years, almost one third of women (32.1%) had died and 16.9% of men (HR 2.33). More than one-third of women (34.2%) experienced MACE within five years compared with 19.8% of men (HR 2.10).
Dr. Martinho said: “Women were two to three times more likely to have adverse outcomes than men in the short and long term, even after adjusting for other conditions and despite receiving PCI at the same time as men.”
The researchers conducted an additional analysis comparing men and women according to risk factors for cardiovascular disease, including hypertension, diabetes, high cholesterol and smoking. Adverse outcomes were then compared between men and women aged 55 and under and men and women over 55.
There were 435 patients in the corresponding analysis. In corresponding patients over 55 years of age, all measured side effects were more common in women than in men. About 11.3% of women died within 30 days compared with 3.0% of men, with an HR of 3.85. Over 5 years, one-third of women (32.9%) had died compared to 15.8% of men (HR 2.35) and over a third of women (34.1%) had experienced MACE compared to 17.6% of men (HR 2, 15). . In matched patients aged 55 years and younger, one in five women (20.0%) experienced a MACE within five years compared with 5.8% of men (HR 3.91), while there was no difference between women and men in all-cause mortality 30 for the day. or five years.
Dr. Martinho said: “Postmenopausal women had worse short-term and long-term outcomes after myocardial infarction than men of the same age. Premenopausal women had similar short-term mortality but a worse long-term prognosis compared to their male counterparts. Our study did not investigate the reasons for these differences, the atypical symptoms of myocardial infarction in women and genetic predisposition may play a role. We found no differences in the use of drugs that lower blood pressure or lipid levels between women and men.”
He concluded: “The findings are another reminder of the need to raise awareness of the risks of heart disease in women. More research is needed to understand why there are gender differences in prognosis after myocardial infarction, so that steps can be taken to close the gap in outcomes.”
HT
Source: ANI
Source: The Nordic Page
