Key result
Female acute myocardial infarction patients with a history of current smoking had a higher 2-year incidence of major adverse cardiac events compared to male patients (aHR 1.264, p=0.052).
Why the study?
The contribution of sex as an independent risk factor for cardiovascular disease remains controversial.
Does female sex worsen long-term clinical outcomes in acute myocardial infarction patients with a history of current smoking after successful DES implantation compared to male sex?
Cohort (n=12,565)
Yes
Does female sex worsen long-term clinical outcomes in acute myocardial infarction patients with a history of current smoking after successful DES implantation compared to male sex?
Hazard Ratio: 1.264 (95% CI 1.001–1.598)
Absolute Event Rate: 10% vs 7.2%
p-value: p=0.052
Among acute myocardial infarction patients with a history of current smoking who underwent successful DES implantation, female sex is associated with significantly worse short- and long-term clinical outcomes, including higher all-cause mortality and recurrent MI, compared to male sex.
BACKGROUND: The contribution of sex as an independent risk factor for cardiovascular disease still remains controversial. The present study investigated the impact of sex on long-term clinical outcomes in Korean acute myocardial infarction (AMI) patients with a history of current smoking on admission after drug-eluting stents (DESs). METHODS: A total of 12,565 AMI patients (male: n = 11,767 vs. female: n = 798) were enrolled. Major adverse cardiac events (MACEs) comprising all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization were the primary outcomes that were compared between the two groups. Probable or definite stent thrombosis (ST) was the secondary outcome. RESULTS: After adjustment, the early (30 days) cumulative incidences of MACEs (adjusted hazard ratio [aHR]: 1.457; 95% confidence interval [CI]: 1.021-2.216; p = 0.035) and all-cause death (aHR: 1.699; 95% CI: 1.074-2.687; p = 0.023) were significantly higher in the female group than in the male group. At 2 years, the cumulative incidences of all-cause death (aHR: 1.561; 95% CI: 1.103-2.210; p = 0.012) and Re-MI (aHR: 1.800; 95% CI: 1.089-2.974; p = 0.022) were significantly higher in the female group than in the male group. However, the cumulative incidences of ST were similar between the two groups (aHR: 1.207; 95% CI: 0.583-2.497; p = 0.613). CONCLUSIONS: The female group showed worse short-term and long-term clinical outcomes compared with the male group comprised of Korean AMI patients with a history of current smoking after successful DES implantation. However, further studies are required to confirm these results.
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Kim et al. (2021) conducted a cohort in Acute myocardial infarction with a history of current smoking (n=12,565). Female sex vs. Male sex was evaluated on Major adverse cardiac events (MACEs) at 2 years (aHR 1.264, 95% CI 1.001-1.598, p=0.052). Female acute myocardial infarction patients with a history of current smoking had a higher 2-year incidence of major adverse cardiac events compared to male patients (aHR 1.264, p=0.052).
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