Gender and age differences in short- and long-term outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction

Su Kiat Chua, Kou Gi Shyu, Huei Fong Hung, Jun Jack Cheng, Huey Ming Lo, Shih Chi Liu, Lung Ching Chen, Ng Zuan Chiu, Che Ming Chang, Shen Chang Lin, Jer Young Liou, Shih Huang Lee

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Abstract

Background: Studies have reported that women with ST elevationmyocardial infarction (STEMI) have worse shortand long-term outcomes than men. It has not yet been confirmed whether these differences reflect differences in age between men and women. Methods: We retrospectively enrolled 1035 consecutive STEMI patients treated with primary percutaneous coronary intervention (PCI). Baseline clinical characteristics, coronary anatomy, and outcome were compared between young (<65 years old) and older patients (≥ 65 years old) of both sexes. Results: Younger women presented with a lower incidence of typical angina (83% vs. 93%, p = 0.03), single-vessel disease (21% vs. 35%, p = 0.03), and total occlusion of infarct-related artery (65% vs. 83%, p = 0.001) than younger men, with no gender difference noted in the older group. Younger women in the study had a higher incidence of reinfarction, heart failure requiring admission, or mortality (23% vs. 6%, p <0.001) during follow-up, compared with younger men, with no gender difference in the older group. Using the Kaplan-Meier analysis, younger women had lower rates of event-free survival (p <0.001 by log-rank test) than younger men, with no gender difference in the older group. In multivariate analysis, age could predict long-term outcome in men (Hazard ratio 4.43, 95% confidence interval: 2.89-6.78, p <0.001) but not in women. Conclusions: In STEMI patients receiving primary PCI, sex-related long-term outcome differences were agedependent, with younger women likely to have a worse long-term outcome when compared with younger men.

Original languageEnglish
Pages (from-to)274-283
Number of pages10
JournalActa Cardiologica Sinica
Volume30
Issue number4
Publication statusPublished - Jul 1 2014

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Percutaneous Coronary Intervention
Infarction
Incidence
Kaplan-Meier Estimate
ST Elevation Myocardial Infarction
Disease-Free Survival
Anatomy
Multivariate Analysis
Heart Failure
Arteries
Confidence Intervals
Mortality

Keywords

  • Coronary heart disease
  • Gender
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Chua, S. K., Shyu, K. G., Hung, H. F., Cheng, J. J., Lo, H. M., Liu, S. C., ... Lee, S. H. (2014). Gender and age differences in short- and long-term outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction. Acta Cardiologica Sinica, 30(4), 274-283.

Gender and age differences in short- and long-term outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction. / Chua, Su Kiat; Shyu, Kou Gi; Hung, Huei Fong; Cheng, Jun Jack; Lo, Huey Ming; Liu, Shih Chi; Chen, Lung Ching; Chiu, Ng Zuan; Chang, Che Ming; Lin, Shen Chang; Liou, Jer Young; Lee, Shih Huang.

In: Acta Cardiologica Sinica, Vol. 30, No. 4, 01.07.2014, p. 274-283.

Research output: Contribution to journalArticle

Chua, SK, Shyu, KG, Hung, HF, Cheng, JJ, Lo, HM, Liu, SC, Chen, LC, Chiu, NZ, Chang, CM, Lin, SC, Liou, JY & Lee, SH 2014, 'Gender and age differences in short- and long-term outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction', Acta Cardiologica Sinica, vol. 30, no. 4, pp. 274-283.
Chua, Su Kiat ; Shyu, Kou Gi ; Hung, Huei Fong ; Cheng, Jun Jack ; Lo, Huey Ming ; Liu, Shih Chi ; Chen, Lung Ching ; Chiu, Ng Zuan ; Chang, Che Ming ; Lin, Shen Chang ; Liou, Jer Young ; Lee, Shih Huang. / Gender and age differences in short- and long-term outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction. In: Acta Cardiologica Sinica. 2014 ; Vol. 30, No. 4. pp. 274-283.
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abstract = "Background: Studies have reported that women with ST elevationmyocardial infarction (STEMI) have worse shortand long-term outcomes than men. It has not yet been confirmed whether these differences reflect differences in age between men and women. Methods: We retrospectively enrolled 1035 consecutive STEMI patients treated with primary percutaneous coronary intervention (PCI). Baseline clinical characteristics, coronary anatomy, and outcome were compared between young (<65 years old) and older patients (≥ 65 years old) of both sexes. Results: Younger women presented with a lower incidence of typical angina (83{\%} vs. 93{\%}, p = 0.03), single-vessel disease (21{\%} vs. 35{\%}, p = 0.03), and total occlusion of infarct-related artery (65{\%} vs. 83{\%}, p = 0.001) than younger men, with no gender difference noted in the older group. Younger women in the study had a higher incidence of reinfarction, heart failure requiring admission, or mortality (23{\%} vs. 6{\%}, p <0.001) during follow-up, compared with younger men, with no gender difference in the older group. Using the Kaplan-Meier analysis, younger women had lower rates of event-free survival (p <0.001 by log-rank test) than younger men, with no gender difference in the older group. In multivariate analysis, age could predict long-term outcome in men (Hazard ratio 4.43, 95{\%} confidence interval: 2.89-6.78, p <0.001) but not in women. Conclusions: In STEMI patients receiving primary PCI, sex-related long-term outcome differences were agedependent, with younger women likely to have a worse long-term outcome when compared with younger men.",
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AU - Chua, Su Kiat

AU - Shyu, Kou Gi

AU - Hung, Huei Fong

AU - Cheng, Jun Jack

AU - Lo, Huey Ming

AU - Liu, Shih Chi

AU - Chen, Lung Ching

AU - Chiu, Ng Zuan

AU - Chang, Che Ming

AU - Lin, Shen Chang

AU - Liou, Jer Young

AU - Lee, Shih Huang

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N2 - Background: Studies have reported that women with ST elevationmyocardial infarction (STEMI) have worse shortand long-term outcomes than men. It has not yet been confirmed whether these differences reflect differences in age between men and women. Methods: We retrospectively enrolled 1035 consecutive STEMI patients treated with primary percutaneous coronary intervention (PCI). Baseline clinical characteristics, coronary anatomy, and outcome were compared between young (<65 years old) and older patients (≥ 65 years old) of both sexes. Results: Younger women presented with a lower incidence of typical angina (83% vs. 93%, p = 0.03), single-vessel disease (21% vs. 35%, p = 0.03), and total occlusion of infarct-related artery (65% vs. 83%, p = 0.001) than younger men, with no gender difference noted in the older group. Younger women in the study had a higher incidence of reinfarction, heart failure requiring admission, or mortality (23% vs. 6%, p <0.001) during follow-up, compared with younger men, with no gender difference in the older group. Using the Kaplan-Meier analysis, younger women had lower rates of event-free survival (p <0.001 by log-rank test) than younger men, with no gender difference in the older group. In multivariate analysis, age could predict long-term outcome in men (Hazard ratio 4.43, 95% confidence interval: 2.89-6.78, p <0.001) but not in women. Conclusions: In STEMI patients receiving primary PCI, sex-related long-term outcome differences were agedependent, with younger women likely to have a worse long-term outcome when compared with younger men.

AB - Background: Studies have reported that women with ST elevationmyocardial infarction (STEMI) have worse shortand long-term outcomes than men. It has not yet been confirmed whether these differences reflect differences in age between men and women. Methods: We retrospectively enrolled 1035 consecutive STEMI patients treated with primary percutaneous coronary intervention (PCI). Baseline clinical characteristics, coronary anatomy, and outcome were compared between young (<65 years old) and older patients (≥ 65 years old) of both sexes. Results: Younger women presented with a lower incidence of typical angina (83% vs. 93%, p = 0.03), single-vessel disease (21% vs. 35%, p = 0.03), and total occlusion of infarct-related artery (65% vs. 83%, p = 0.001) than younger men, with no gender difference noted in the older group. Younger women in the study had a higher incidence of reinfarction, heart failure requiring admission, or mortality (23% vs. 6%, p <0.001) during follow-up, compared with younger men, with no gender difference in the older group. Using the Kaplan-Meier analysis, younger women had lower rates of event-free survival (p <0.001 by log-rank test) than younger men, with no gender difference in the older group. In multivariate analysis, age could predict long-term outcome in men (Hazard ratio 4.43, 95% confidence interval: 2.89-6.78, p <0.001) but not in women. Conclusions: In STEMI patients receiving primary PCI, sex-related long-term outcome differences were agedependent, with younger women likely to have a worse long-term outcome when compared with younger men.

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