Among octogenarians with STEMI, women had higher in-hospital mortality (OR 1.13) and composite outcomes (OR 1.22) versus men; primary PCI reduced these risks significantly.
Does female sex increase the risk of adverse clinical outcomes in octogenarians with STEMI compared to male sex?
Among octogenarians with STEMI, women have a significantly higher risk of in-hospital mortality and adverse outcomes compared to men, though primary PCI reduces this risk.
Absolute Event Rate: 0% vs 0%
Abstract Backgrounds and aims Women have a worse prognosis after ST-segment elevation myocardial infarction (STEMI) than men. However, it is unclear if these differences persist among octogenarians. This study aimed to assess sex-related differences in clinical outcomes of octogenarians with STEMI. Methods This is a country-wide population-based cohort study performed on octogenarians with STEMI between January 2014 and December 2021 based on the China Cardiovascular Association (CCA) Database- Chest Pain Center and Chest Pain Center (CPC). Multivariable logistic regression and inverse probability of treatment weighted (IPTW) logistic regression models were used to assess the risk of clinical outcomes between men and women. Results There were 22155 women with a mean (SD) age of 84.3 (3.7) years and 24402 men with a mean (SD) age of 83.8 (3.4) years included in the study. Following multivariable controlled for comorbidities and treatment covariates, women exhibited a higher risk of in-hospital mortality (odds ratio OR, 1.13; 95% confidence interval CI, 1.05- 1.21) and the composite outcome (OR, 1.22; 95% CI, 1.16- 1.27) compare to men, regardless of whether they received a primary percutaneous coronary intervention (PCI) strategy or not. Meanwhile, the primary PCI strategy was associated with a reduced risk of in-hospital mortality (OR, 0.61; 95% CI, 0.55- 0.68) and the composite outcome (OR, 0.78; 95% CI, 0.73- 0.84) among female octogenarians with STEMI. These significant associations persisted after adjusting for baseline clinical covariates by IPTW analysis. Furthermore, subgroup analysis indicated that women were consistently associated with an elevated risk of in-hospital mortality or the composite outcome across most subgroups, and the primary PCI strategy mitigated these risks. During a median follow-up of 6.6 months post-hospital admission, there was a percentage 31.6% of patients died, and women patients consistently demonstrated an increased incidence of all-cause mortality (hazard ratio (HR) = 1.16, 95% CI: 1.12–1.21, P 0.001) Conclusions Among octogenarians with STEMI in China, women exhibited a significantly positive correlation with in-hospital mortality and the composite outcome. Additionally, the primary PCI strategy may mitigate the risk of adverse clinical outcomes.Association of sex differences
Guan et al. (Sat,) reported a other. Among octogenarians with STEMI, women had higher in-hospital mortality (OR 1.13) and composite outcomes (OR 1.22) versus men; primary PCI reduced these risks significantly.
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