Women with STEMI had a higher incidence of de novo heart failure at presentation than men (25.1% vs. 20.0%; OR 1.34, 95% CI 1.21-1.48) and higher 30-day mortality.
Cohort (n=10,443)
Yes
Does female sex increase the risk of de novo heart failure and 30-day mortality in patients presenting with STEMI?
Women presenting with STEMI have a significantly higher risk of developing de novo heart failure and subsequent 30-day mortality compared to men, highlighting a critical sex-based disparity in post-MI outcomes.
Odds Ratio: 1.34 (95% CI 1.21–1.48)
Absolute Event Rate: 25.1% vs 20%
BACKGROUND ST-segment elevation myocardial infarction (STEMI) complicated by symptoms of acute de novo heart failure is associated with excess mortality. Whether development of heart failure and its outcomes differ by sex is unknown. OBJECTIVES This study sought to examine the relationships among sex, acute heart failure, and related outcomes after STEMI in patients with no prior history of heart failure recorded at baseline. METHODS Patients were recruited from a network of hospitals in the ISACS-TC (International Survey of Acute Coronary Syndromes in Transitional Countries) registry (NCT01218776). Main outcome measures were incidence of Killip class ≥II at hospital presentation and risk-adjusted 30-day mortality rates were estimated using inverse probability of weighting and logistic regression models. RESULTS This study included 10,443 patients (3,112 women). After covariate adjustment and matching for age, cardiovascular risk factors, comorbidities, disease severity, and delay to hospital presentation, the incidence of de novo heart failure at hospital presentation was significantly higher for women than for men (25.1% vs. 20.0%, odds ratio OR: 1.34; 95% confidence interval CI: 1.21 to 1.48). Women with de novo heart failure had higher 30-day mortality than did their male counterparts (25.1% vs. 20.6%; OR: 1.29; 95% CI: 1.05 to 1.58). The sex-related difference in mortality rates was still apparent in patients with de novo heart failure undergoing reperfusion therapy after hospital presentation (21.3% vs. 15.7%; OR: 1.45; 95% CI: 1.07 to 1.96). CONCLUSIONS Women are at higher risk to develop de novo heart failure after STEMI and women with de novo heart failure have worse survival than do their male counterparts. Therefore, de novo heart failure is a key feature to explain mortality gap after STEMI among women and men.
Cenko et al. (Fri,) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=10,443). Female sex vs. Male sex was evaluated on Incidence of de novo heart failure (Killip class ≥II) at hospital presentation (OR 1.34, 95% CI 1.21-1.48). Women with STEMI had a higher incidence of de novo heart failure at presentation than men (25.1% vs. 20.0%; OR 1.34, 95% CI 1.21-1.48) and higher 30-day mortality.