Why the study?
Does female gender independently increase the risk of early and late mortality in patients with STEMI across different age groups?
Does female gender independently increase the risk of early and late mortality in patients with STEMI across different age groups?
Higher early and late mortality observed in younger women with STEMI is driven by worse baseline characteristics, delayed presentation, and more frequent bleeding rather than an independent effect of gender.
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Adjusted STEMI mortality shows no independent gender association; challenges assumptions of inherent risk and leaves open further confounder exploration.
BACKGROUND: Although previous studies using Korean data have already reported higher rates of mortality in women, it is less clear whether these gender differences in prognosis post ST-segment elevation myocardial infarction (STEMI), are age dependent. The aim of this study is to examine the gender-age interaction with early and late mortality in patients with STEMI enrolled in the Korean nationwide registry. METHODS: This prospective study stratified outcomes according to gender and age from 17,021 STEMI patients. We compared in-hospital, early (30 days) and late (12 months) mortality between gender to examine the gender-age interaction in multivariable models. RESULTS: > 0.001; unadjusted OR: 2.33, 95% CI: 2.08-2.61) were significantly higher compared with men. However, after adjustment for patient characteristics, Killip class ≥ 3, symptom to balloon time and major bleeding, and in-hospital bleeding, overall early and late mortality were no longer related to gender in any age groups. CONCLUSIONS: Among a Korean population with STEMI, higher early and late mortality in younger women may be explained by poor patient characteristics, higher Killip class ≥ 3, longer symptom to balloon time and more frequent major bleeding. Therefore, based on gender-age differences, more precise and aggressive preventive strategies focused on risk factor reduction, education and more intensive management for younger women should be performed.
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Her et al. (2018) studied this question.
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