Key result
Female sex and older age are linked to higher mortality and post-MI HF.
Why the study?
How sex and age influence post-myocardial infarction outcomes remains unclear.
How do sex and age influence cardiovascular mortality and heart failure hospitalization in patients post-myocardial infarction undergoing PCI?
Cohort (n=643)
How do sex and age influence cardiovascular mortality and heart failure hospitalization in patients post-myocardial infarction undergoing PCI?
Female patients, particularly older females, face higher risks of mortality and heart failure following a first myocardial infarction treated with PCI, highlighting a need for improved, sex-specific management.
May support closer monitoring of older females post-MI; leaves open whether sex-specific strategies improve outcomes.
BACKGROUND: How sex and age influence post-myocardial infarction (post-MI) outcomes remains unclear. This study evaluated the influence of sex and age on drug therapy, echocardiographic parameters, and outcomes in post-MI patients undergoing percutaneous coronary intervention (PCI). METHODS: We retrospectively enrolled 643 patients with first acute MI who underwent successful PCI and two echocardiographic examinations within 1 year after MI. Clinical characteristics and 4-year follow-up outcomes were compared between sexes and age groups. Primary endpoints were cardiovascular mortality and hospitalization for heart failure (HF). RESULTS: Compared with males, female patients with MI, particularly older females, had more systemic diseases. Younger females received fewer guideline-directed therapies. Older patients presented with higher left ventricular volume and mass index but no significant differences in left ventricular ejection fraction. The Kaplan-Meier analysis revealed increased mortality in both younger and older females. Elderly patients, particularly older females, exhibited significantly higher post-MI HF incidence but no difference in recurrent MI, ventricular arrhythmia, or revascularization. CONCLUSIONS: In MI patients receiving PCI, outcome differences between sexes are age-dependent. Age influences outcome more heavily in females than in males. Females are likely to exhibit worse overall survival, and older females are at higher risk of post-MI HF.
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Shih et al. (2019) conducted a cohort in post-myocardial infarction (n=643). Female sex and older age vs. Male sex and younger age was evaluated on Cardiovascular mortality and hospitalization for heart failure (HF). Female sex and older age were associated with increased mortality and higher incidence of post-MI heart failure, with age influencing outcomes more heavily in females than in males.
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