Sex, adverse cardiac events, and infarct size in anterior myocardial infarction: An analysis of Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction (INFUSE-AMI) - 10/12/14
, Sorin J. Brener, MD b, c, Akiko Maehara, MD b, d, Bernhard Witzenbichler, MD e, José M. Dizon, MD d, Magdi El-Omar, MBBS, MRCP f, Ke Xu, PhD b, C. Michael Gibson, MD g, Gregg W. Stone, MD b, dRésumé |
Background |
Women are more likely than men to experience adverse cardiac events after ST-elevation myocardial (STEMI). Whether differences in infarct size or reperfusion contribute to sex differences in outcomes is unknown.
Methods |
We compared baseline and procedural characteristics, angiographic and electrocardiographic indices of reperfusion, microvascular obstruction, infarct size, and clinical outcomes in 118 women and 334 men with anterior STEMI enrolled in the INFUSE-AMI randomized trial of intralesion abciximab and aspiration thrombectomy (NCT00976521). Infarct size was assessed by cardiac magnetic resonance imaging at 30days, and clinical end points were adjudicated by an independent committee.
Results |
Women were older, were more commonly affected by hypertension and renal impairment, and had a 50.5-minute longer delay to reperfusion. There were no differences in infarct size, microvascular obstruction, or reperfusion success. At 30days, major adverse cardiac events (MACE), defined as death, reinfarction, new-onset severe heart failure, or rehospitalization for heart failure, were more common in women (11.1% vs 5.4%, hazard ratio 2.09, 95% CI 1.03-4.27, P = .04). After multivariable adjustment, age, but not sex or time to reperfusion, was an independent predictor of MACE.
Conclusions |
In the INFUSE-AMI randomized trial, women with anterior STEMI experienced a higher rate of MACE, attributable to older age. Despite longer delay from symptom onset to reperfusion therapy, there was no difference between women and men in infarct size or reperfusion success.
Le texte complet de cet article est disponible en PDF.Plan
| RCT No. NCT00976521. |
Vol 169 - N° 1
P. 86-93 - janvier 2015 Retour au numéro
Article précédent
- National trends in stroke after acute myocardial infarction among Medicare patients in the United States: 1999 to 2010
- Yun Wang, Judith H. Lichtman, Kumar Dharmarajan, Frederick A. Masoudi, Joseph S. Ross, John A. Dodson, Jersey Chen, John A. Spertus, Sarwat I. Chaudhry, Brahmajee K. Nallamothu, Harlan M. Krumholz
- Hemoglobin levels and new-onset heart failure in the community
- IJsbrand T. Klip, Douwe Postmus, Adriaan A. Voors, Frank P.J. Brouwers, Ron T. Gansevoort, Stephan J.L. Bakker, Hans L. Hillege, Rudolf A. de Boer, Pim van der Harst, Wiek H. van Gilst, Dirk J. van Veldhuisen, Peter van der Meer
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?