Unrecognized myocardial infarction increased heart failure risk in men (HR 1.90; 95% CI 1.45-2.48), but the increased risk in women (HR 1.31; 95% CI 1.01-1.71) lost significance after adjustment.
Cohort (n=12,303)
Does unrecognized myocardial infarction worsen long-term prognosis (HF, AF, stroke, mortality) compared to no myocardial infarction in men and women from the general population?
Unrecognized myocardial infarction carries a significant long-term risk for adverse cardiovascular outcomes and mortality in men, but this association is attenuated by cardiovascular risk factors in women.
BACKGROUND: Unrecognized myocardial infarction (UMI) is associated with an adverse prognosis, but sex-specific differences in outcomes are not fully understood. METHODS: We included 12,303 participants (57.6% women, mean age 64.8 years) from the Rotterdam Study. Baseline MI status (1990-2008) was determined by ECG and medical records, categorizing participants as UMI (n = 512), recognized MI (RMI) (n = 669), or no MI (n = 11,122). Outcomes included heart failure (HF), atrial fibrillation (AF), stroke, and all-cause mortality. RESULTS: In women, compared to no MI, UMI was associated with larger risks of HF (HR 1.31, 95%CI 1.01-1.71) and all-cause mortality (HR 1.21, 95%CI 1.05-1.40), but lost significance after adjusting for cardiovascular risk factors. UMI was nonsignificantly associated with a larger risk of stroke (HR 1.27, 95%CI 0.95-1.70), but not AF (HR 0.96, 95%CI 0.70-1.33). RMI in women significantly increased risks of HF (HR 2.58, 95%CI 1.94-3.43), AF (HR 1.62, 95%CI 1.13-2.32), and all-cause mortality (HR 1.81, 95%CI 1.54-2.12), but not stroke (HR 1.41, 95%CI 0.98-2.04). Among men, both UMI and RMI were associated with larger risks of HF (UMI: HR 1.90, 95%CI 1.45-2.48, RMI: HR 2.49, 95%CI 2.09-2.98), AF (UMI: HR 1.91, 95%CI 1.45-2.54, RMI: HR 1.79, 95%CI 1.46-2.19), stroke (UMI: HR 2.06, 95%CI 1.52-2.80, RMI: HR 1.36, 95%CI 1.06-1.76), and all-cause mortality (UMI: HR 1.59, 95%CI 1.36-1.85, RMI: HR 1.63, 95%CI 1.46-1.81). CONCLUSIONS: UMI has a differential impact on the long-term prognosis in women and men, highlighting the need to identify key predictors of adverse outcomes.
Oortmerssen et al. (Fri,) conducted a cohort in Unrecognized myocardial infarction (n=12,303). Unrecognized myocardial infarction vs. No MI was evaluated on Heart failure, atrial fibrillation, stroke, and all-cause mortality. Unrecognized myocardial infarction increased heart failure risk in men (HR 1.90; 95% CI 1.45-2.48), but the increased risk in women (HR 1.31; 95% CI 1.01-1.71) lost significance after adjustment.
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