Contemporary Trends and Age‐Specific Sex Differences in Management and Outcome for Patients With ST‐Segment Elevation Myocardial Infarction
BackgroundAge‐ and sex‐specific differences exist in the treatment and outcome of ST‐elevation myocardial infarction (STEMI). We sought to describe age‐ and sex‐matched contemporary trends of in‐hospital management and outcome of patients with STEMI. Methods and ResultsWe analyzed data from 5 Italia...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2016-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004202 |
| _version_ | 1818315202373877760 |
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| author | Leonardo De Luca Marco Marini Lucio Gonzini Alessandro Boccanelli Gianni Casella Francesco Chiarella Stefano De Servi Antonio Di Chiara Giuseppe Di Pasquale Zoran Olivari Giorgio Caretta Laura Lenatti Michele Massimo Gulizia Stefano Savonitto |
| author_facet | Leonardo De Luca Marco Marini Lucio Gonzini Alessandro Boccanelli Gianni Casella Francesco Chiarella Stefano De Servi Antonio Di Chiara Giuseppe Di Pasquale Zoran Olivari Giorgio Caretta Laura Lenatti Michele Massimo Gulizia Stefano Savonitto |
| author_sort | Leonardo De Luca |
| collection | DOAJ |
| description | BackgroundAge‐ and sex‐specific differences exist in the treatment and outcome of ST‐elevation myocardial infarction (STEMI). We sought to describe age‐ and sex‐matched contemporary trends of in‐hospital management and outcome of patients with STEMI. Methods and ResultsWe analyzed data from 5 Italian nationwide prospective registries, conducted between 2001 and 2014, including consecutive patients with STEMI. All the analyses were age‐ and sex‐matched, considering 4 age classes: <55, 55 to 64, 65 to 74, and ≥75 years. A total of 13 235 patients were classified as having STEMI (72.1% men and 27.9% women). A progressive shift from thrombolysis to primary percutaneous coronary intervention occurred over time, with a concomitant increase in overall reperfusion rates (P for trend <0.0001), which was consistent across sex and age classes. The crude rates of in‐hospital death were 3.2% in men and 8.4% in women (P<0.0001), with a significant increase over age classes for both sexes and a significant decrease over time for both sexes (all P for trend <0.01). On multivariable analysis, age (odds ratio 1.09, 95% CI 1.07–1.10, P<0.0001) and female sex (odds ratio 1.44, 95% CI 1.07–1.93, P=0.009) were found to be significantly associated with in‐hospital mortality after adjustment for other risk factors, but no significant interaction between these 2 variables was observed (P for interaction=0.61). ConclusionsDespite a nationwide shift from thrombolytic therapy to primary percutaneous coronary intervention for STEMI affecting both sexes and all ages, women continue to experience higher in‐hospital mortality than men, irrespective of age. |
| first_indexed | 2024-12-13T09:01:47Z |
| format | Article |
| id | doaj.art-69b7621b1dfb4b49a6b53c4b30c6dad9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T09:01:47Z |
| publishDate | 2016-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-69b7621b1dfb4b49a6b53c4b30c6dad92022-12-21T23:53:09ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-12-0151210.1161/JAHA.116.004202Contemporary Trends and Age‐Specific Sex Differences in Management and Outcome for Patients With ST‐Segment Elevation Myocardial InfarctionLeonardo De Luca0Marco Marini1Lucio Gonzini2Alessandro Boccanelli3Gianni Casella4Francesco Chiarella5Stefano De Servi6Antonio Di Chiara7Giuseppe Di Pasquale8Zoran Olivari9Giorgio Caretta10Laura Lenatti11Michele Massimo Gulizia12Stefano Savonitto13Division of Cardiology, San Giovanni Evangelista Hospital, Tivoli (Rome), ItalyDepartment of Cardiovascular Sciences, Ospedali Riuniti, Ancona, ItalyANMCO Research Center, Florence, ItalyDepartment of Cardiovascular Diseases, S. Giovanni‐Addolorata Hospital, Rome, ItalyDepartment of Cardiology, Maggiore Hospital, Bologna, ItalyDivision of Cardiology, Azienda Ospedaliera‐Universitaria S. Martino, Genova, ItalyDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyDivision of Cardiology, Ospedale Sant'Antonio Abate, Tolmezzo, ItalyDepartment of Cardiology, Maggiore Hospital, Bologna, ItalyDepartment of Cardiology, Ca’ Foncello Hospital, Treviso, ItalyDivision of Cardiology, Sant'Andrea Hospital, ASL 5 Liguria, La Spezia, ItalyDivision of Cardiology, Ospedale A. Manzoni, Lecco, ItalyDivision of Cardiology, Garibaldi‐Nesima Hospital, Catania, ItalyDivision of Cardiology, Ospedale A. Manzoni, Lecco, ItalyBackgroundAge‐ and sex‐specific differences exist in the treatment and outcome of ST‐elevation myocardial infarction (STEMI). We sought to describe age‐ and sex‐matched contemporary trends of in‐hospital management and outcome of patients with STEMI. Methods and ResultsWe analyzed data from 5 Italian nationwide prospective registries, conducted between 2001 and 2014, including consecutive patients with STEMI. All the analyses were age‐ and sex‐matched, considering 4 age classes: <55, 55 to 64, 65 to 74, and ≥75 years. A total of 13 235 patients were classified as having STEMI (72.1% men and 27.9% women). A progressive shift from thrombolysis to primary percutaneous coronary intervention occurred over time, with a concomitant increase in overall reperfusion rates (P for trend <0.0001), which was consistent across sex and age classes. The crude rates of in‐hospital death were 3.2% in men and 8.4% in women (P<0.0001), with a significant increase over age classes for both sexes and a significant decrease over time for both sexes (all P for trend <0.01). On multivariable analysis, age (odds ratio 1.09, 95% CI 1.07–1.10, P<0.0001) and female sex (odds ratio 1.44, 95% CI 1.07–1.93, P=0.009) were found to be significantly associated with in‐hospital mortality after adjustment for other risk factors, but no significant interaction between these 2 variables was observed (P for interaction=0.61). ConclusionsDespite a nationwide shift from thrombolytic therapy to primary percutaneous coronary intervention for STEMI affecting both sexes and all ages, women continue to experience higher in‐hospital mortality than men, irrespective of age.https://www.ahajournals.org/doi/10.1161/JAHA.116.004202percutaneous coronary interventionregistrysexST‐segment elevation myocardial infarction |
| spellingShingle | Leonardo De Luca Marco Marini Lucio Gonzini Alessandro Boccanelli Gianni Casella Francesco Chiarella Stefano De Servi Antonio Di Chiara Giuseppe Di Pasquale Zoran Olivari Giorgio Caretta Laura Lenatti Michele Massimo Gulizia Stefano Savonitto Contemporary Trends and Age‐Specific Sex Differences in Management and Outcome for Patients With ST‐Segment Elevation Myocardial Infarction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease percutaneous coronary intervention registry sex ST‐segment elevation myocardial infarction |
| title | Contemporary Trends and Age‐Specific Sex Differences in Management and Outcome for Patients With ST‐Segment Elevation Myocardial Infarction |
| title_full | Contemporary Trends and Age‐Specific Sex Differences in Management and Outcome for Patients With ST‐Segment Elevation Myocardial Infarction |
| title_fullStr | Contemporary Trends and Age‐Specific Sex Differences in Management and Outcome for Patients With ST‐Segment Elevation Myocardial Infarction |
| title_full_unstemmed | Contemporary Trends and Age‐Specific Sex Differences in Management and Outcome for Patients With ST‐Segment Elevation Myocardial Infarction |
| title_short | Contemporary Trends and Age‐Specific Sex Differences in Management and Outcome for Patients With ST‐Segment Elevation Myocardial Infarction |
| title_sort | contemporary trends and age specific sex differences in management and outcome for patients with st segment elevation myocardial infarction |
| topic | percutaneous coronary intervention registry sex ST‐segment elevation myocardial infarction |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004202 |
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