Sex Differences Among Young Patients With ST‐Segment–Elevation Myocardial Infarction: A Systematic Review and Meta‐Analysis

Figures

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  Figure 1. Preferred Reporting Items for Systematic Reviews and Meta‐Analysis flowchart. A systematic review was performed on Pubmed, Embase, and Cochrane Central Register of Controlled Trials, with a total of 8771 results. After excluding 1604 duplicates and 7407 articles based on title and abstract screening, a total of 300 articles were reviewed in full. Finally, 11 articles were included in the meta‐analysis. STEMI indicates ST‐segment–elevation myocardial infarction.

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  Figure 2. In‐hospital all‐cause death. Nine studies analyzed in‐hospital death, with a total of 688 events in 159 141 women and 1552 in 530 931 men, resulting in a significant higher mortality rate in women (RR, 1.56 [95% CI, 1.40–1.74]; P<0.001; τ=0.04; I 2=0%). MH indicates Mantel–Haenszel; and RR, relative risk.

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  Figure 3. One‐year all‐cause death. Six studies analyzed 1‐year all‐cause death, with a total of 167 events in 2482 women and 420 in 10 809 men, resulting in a significantly higher mortality rate in women (RR, 1.78 [95% CI, 1.50–2.12]; P<0.001; τ=0.00; I 2=0%). MH indicates Mantel–Haenszel; and RR, relative risk.

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  Figure 4. Coronary disease extent: single‐artery disease. Five studies examined the distribution of coronary artery disease, revealing that 1280 of 1758 women (73%) had single‐vessel disease, compared with 4145 of 6878 men (60%). This resulted in a significantly higher relative prevalence of single‐artery disease in women (RR, 1.13 [95% CI, 1.03–1.23]; P=0.006; τ=0.07; I 2=67%). MH indicates Mantel–Haenszel; and RR, relative risk.

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  Figure 5. Coronary disease extent: 2‐artery disease. A 2‐artery disease was found in 310 of 1758 women (18%), compared with 1602 of 6878 men (23%). This resulted in a significant relatively lower prevalence of 2‐artery disease in women (RR, 0.76 [95% CI, 0.68–0.85]; P<0.001; τ=0.00; I 2=0%). MH indicates Mantel–Haenszel; and RR, relative risk.

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  Figure 6. Coronary disease extent: 3‐artery disease. A 3‐artery disease was found in 162 of 1758 women (9%), compared with 1120 of 6878 men (16%). This did not result in a statistically significant difference between sexes (RR, 0.49 [95% CI, 0.27–0.86]; P=0.014; τ=0.41; I 2=33%). MH indicates Mantel–Haenszel; and RR, relative risk.