Key result
Male gender was an independent predictor of 1-year major adverse cardiac events compared to female gender in elderly patients with acute myocardial infarction (HR 1.37).
Why the study?
Although gender differences are known to associate with clinical outcomes in acute myocardial infarction, whether they affect the prognosis of elderly patients remained unclear.
Does female gender improve clinical outcomes in elderly patients with acute myocardial infarction compared to male gender?
Cohort (n=2,953)
Yes
Does female gender improve clinical outcomes in elderly patients with acute myocardial infarction compared to male gender?
Hazard Ratio: 1.37 (95% CI 1.14–1.65)
Absolute Event Rate: 12.6% vs 11.6%
p-value: p=<0.001
In elderly patients (≥75 years) with acute myocardial infarction, female gender is associated with a more favorable 1-year prognosis compared to male gender, despite similar in-hospital mortality.
May support gender-informed risk stratification in elderly AMI; hypothesis-generating and requires prospective validation.
Background/Aims: It is well known that gender differences are associated with clinical outcomes in patients with acute myocardial infarction (AMI). However, it is not clear whether gender differences affect the prognosis of elderly patients with AMI. Methods: We analyzed the incidence of in-hospital complications and mortality in the Korea Acute Myocardial Infarction Registry-National Institutes of Health from November 2011 to June 2015. This study included elderly patients ( 75 years) diagnosed with AMI. Results: A total of 2,953 patients were eligible for this study. Among them, 1,529 (51.8%) patients were female, and the mean age of the female group was older than that of the male group (80.7 4.4 vs. 79.6 4.0 years, respectively, p < 0.001). Elderly females utilized emergency medical services less frequently compared with elderly males (11.5 vs. 15.4%, respectively, p < 0.001). Elderly female AMI patients had a similar rate of in-hospital mortality compared with elderly males (7.1 vs. 8.4%, respectively, p = 0.196). The rate of major cardiac adverse events (MACEs) was lower in elderly females than males during a 12-month follow-up (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.00-1.41, p = 0.045). According to multivariate analysis, the male gender is an independent factor for predicting 1-year MACEs (HR 1.37, 95% CI 1.14-1.65, p < 0.001). Conclusions: No significant differences in peri-procedural complications or in-hospital mortality were observed between male and female elderly patients with AMI. However, elderly female patients had a more favorable prognosis than male patients during a 1-year clinical follow-up. (
No takes yet. Share an insight, caveat, or question.
Seol et al. (2019) conducted a cohort in Acute Myocardial Infarction (n=2,953). Male gender vs. Female gender was evaluated on 1-year major adverse cardiac events (MACEs) (HR 1.37, 95% CI 1.14-1.65, p=<0.001). Male gender was an independent predictor of 1-year major adverse cardiac events compared to female gender in elderly patients with acute myocardial infarction (HR 1.37).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: