Age-related loss of Y chromosome is associated with mortality after ST-segment elevation myocardial infarction

While loss of Y chromosome (LOY), a common somatic alteration with aging, has been associated with cardiovascular diseases, its specific impact on ST-segment elevation myocardial infarction (STEMI) remains underexplored. This study enrolled 928 males undergoing primary percutaneous coronary intervention for STEMI to investigate the impact of LOY in blood cells on all-cause mortality. LOY was measured in males using droplet digital polymerase chain reaction technique. The primary outcome was all-cause mortality. During a median of 3.99-year follow-up, 93 males (10.0%) died. Of these, 39 (4.2%) died within 1 year, 56 (6.0%) within 2 years, and 67 (7.2%) within 3 years. Compared to males with LOY < 18% (the 90th percentile), those with LOY ≥ 18% had an increased mortality after multivariable adjustment including age, with adjusted hazard ratios (HRs) of 2.45 (95% confidence interval [CI]: 1.16–5.15; P = 0.018), 2.11 (95% CI: 1.11–4.01; P = 0.024), and 1.88 (95% CI: 1.02–3.45; P = 0.043) at 1-, 2-, and 3-year follow-up, respectively. Among males without prior MI, those with LOY ≥ 18% have higher mortality than those with LOY < 18% (adjusted HR 1.93; 95% CI: 1.01–3.67; P = 0.045), whereas no significant association is observed in males with prior MI. LOY ( ≥ 18%) is associated with an increased 1-, 2-, and 3-year mortality in male STEMI patients and may serve as a potential biomarker for risk stratification. As people age, some men lose the Y chromosome in a portion of their blood cells, a change called loss of the Y chromosome (LOY). Severe heart attacks caused by blocked coronary arteries (called ST-segment elevation myocardial infarction, STEMI) can be life-threatening, and better ways to identify high -risk patients are needed. In this study, we followed patients admitted to hospital with STEMI for nearly four years and compared survival between patients with high and low levels of LOY. Our results demonstrate that men with high LOY have a higher risk of death, even after considering age and other heart disease risk factors. These findings suggest that measuring LOY could help identify male STEMI patients at higher risk and may support more personalized follow-up and risk assessment in the future. Li, Li, Tan et al. investigate the impact of loss of Y chromosome (LOY) in blood cells on all-cause mortality in male patients with ST-segment elevation myocardial infarction. The results demonstrate that high LOY level is associated with an increased risk of mortality, independent of age and traditional cardiovascular risk factors.