Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean acute myocardial infarction national registry)

Si Hyuck Kang, Jung Won Suh, Chang Hwan Yoon, Myeong Chan Cho, Young Jo Kim, Shung Chull Chae, Jung Han Yoon, Hyeon Cheol Gwon, Kyoo Rok Han, Joo Han Kim, Young Keun Ahn, Myung Ho Jeong, Hyo Soo Kim, Dong Ju Choi

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Abstract

There has been controversy over the disparity between men and women with regard to the management and prognosis of acute myocardial infarction. Analyzing nationwide multicenter prospective registries in Korea, the aim of this study was to determine whether female gender independently imposes a risk for mortality. Data from 14,253 patients who were hospitalized for ST-segment elevation myocardial infarction from November 2005 to September 2010 were extracted from registries. Compared to men, women were older (mean age 56 ± 12 vs 67 ± 10 years, p <0.001), and female gender was associated with a higher frequency of co-morbidities, including hypertension, diabetes, and dyslipidemia. Women had longer pain-to-door time and more severe hemodynamic status than men. All-cause mortality rates were 13.6% in women and 7.0% in men at 1 year after the index admission (hazard ratio for women 2.01, 95% confidence interval 1.80 to 2.25, p <0.001). The risk for death after ST-segment elevation myocardial infarction corresponded highly with age. Although the risk remained high after adjusting for age, further analyses adjusting for medical history, clinical performance, and hemodynamic status diminished the gender effect (hazard ratio 1.00, 95% confidence interval 0.86 to 1.17, p = 0.821). Propensity score matching, as a sensitivity analysis, corroborated the results. In conclusion, this study shows that women have a comparable risk for death after ST-segment elevation myocardial infarction as men. The gender effect was accounted for mostly by the women's older age, complex co-morbidities, and severe hemodynamic conditions at presentation.

Original languageEnglish
Pages (from-to)787-793
Number of pages7
JournalAmerican Journal of Cardiology
Volume109
Issue number6
DOIs
Publication statusPublished - 2012 Mar 15

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Sex Characteristics
Registries
Myocardial Infarction
Mortality
Hemodynamics
Confidence Intervals
Morbidity
Propensity Score
Korea
Dyslipidemias
ST Elevation Myocardial Infarction
Hypertension
Pain

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kang, Si Hyuck ; Suh, Jung Won ; Yoon, Chang Hwan ; Cho, Myeong Chan ; Kim, Young Jo ; Chae, Shung Chull ; Yoon, Jung Han ; Gwon, Hyeon Cheol ; Han, Kyoo Rok ; Kim, Joo Han ; Ahn, Young Keun ; Jeong, Myung Ho ; Kim, Hyo Soo ; Choi, Dong Ju. / Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean acute myocardial infarction national registry). In: American Journal of Cardiology. 2012 ; Vol. 109, No. 6. pp. 787-793.
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title = "Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean acute myocardial infarction national registry)",
abstract = "There has been controversy over the disparity between men and women with regard to the management and prognosis of acute myocardial infarction. Analyzing nationwide multicenter prospective registries in Korea, the aim of this study was to determine whether female gender independently imposes a risk for mortality. Data from 14,253 patients who were hospitalized for ST-segment elevation myocardial infarction from November 2005 to September 2010 were extracted from registries. Compared to men, women were older (mean age 56 ± 12 vs 67 ± 10 years, p <0.001), and female gender was associated with a higher frequency of co-morbidities, including hypertension, diabetes, and dyslipidemia. Women had longer pain-to-door time and more severe hemodynamic status than men. All-cause mortality rates were 13.6{\%} in women and 7.0{\%} in men at 1 year after the index admission (hazard ratio for women 2.01, 95{\%} confidence interval 1.80 to 2.25, p <0.001). The risk for death after ST-segment elevation myocardial infarction corresponded highly with age. Although the risk remained high after adjusting for age, further analyses adjusting for medical history, clinical performance, and hemodynamic status diminished the gender effect (hazard ratio 1.00, 95{\%} confidence interval 0.86 to 1.17, p = 0.821). Propensity score matching, as a sensitivity analysis, corroborated the results. In conclusion, this study shows that women have a comparable risk for death after ST-segment elevation myocardial infarction as men. The gender effect was accounted for mostly by the women's older age, complex co-morbidities, and severe hemodynamic conditions at presentation.",
author = "Kang, {Si Hyuck} and Suh, {Jung Won} and Yoon, {Chang Hwan} and Cho, {Myeong Chan} and Kim, {Young Jo} and Chae, {Shung Chull} and Yoon, {Jung Han} and Gwon, {Hyeon Cheol} and Han, {Kyoo Rok} and Kim, {Joo Han} and Ahn, {Young Keun} and Jeong, {Myung Ho} and Kim, {Hyo Soo} and Choi, {Dong Ju}",
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Kang, SH, Suh, JW, Yoon, CH, Cho, MC, Kim, YJ, Chae, SC, Yoon, JH, Gwon, HC, Han, KR, Kim, JH, Ahn, YK, Jeong, MH, Kim, HS & Choi, DJ 2012, 'Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean acute myocardial infarction national registry)', American Journal of Cardiology, vol. 109, no. 6, pp. 787-793. https://doi.org/10.1016/j.amjcard.2011.11.006

Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean acute myocardial infarction national registry). / Kang, Si Hyuck; Suh, Jung Won; Yoon, Chang Hwan; Cho, Myeong Chan; Kim, Young Jo; Chae, Shung Chull; Yoon, Jung Han; Gwon, Hyeon Cheol; Han, Kyoo Rok; Kim, Joo Han; Ahn, Young Keun; Jeong, Myung Ho; Kim, Hyo Soo; Choi, Dong Ju.

In: American Journal of Cardiology, Vol. 109, No. 6, 15.03.2012, p. 787-793.

Research output: Contribution to journalArticle

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T1 - Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean acute myocardial infarction national registry)

AU - Kang, Si Hyuck

AU - Suh, Jung Won

AU - Yoon, Chang Hwan

AU - Cho, Myeong Chan

AU - Kim, Young Jo

AU - Chae, Shung Chull

AU - Yoon, Jung Han

AU - Gwon, Hyeon Cheol

AU - Han, Kyoo Rok

AU - Kim, Joo Han

AU - Ahn, Young Keun

AU - Jeong, Myung Ho

AU - Kim, Hyo Soo

AU - Choi, Dong Ju

PY - 2012/3/15

Y1 - 2012/3/15

N2 - There has been controversy over the disparity between men and women with regard to the management and prognosis of acute myocardial infarction. Analyzing nationwide multicenter prospective registries in Korea, the aim of this study was to determine whether female gender independently imposes a risk for mortality. Data from 14,253 patients who were hospitalized for ST-segment elevation myocardial infarction from November 2005 to September 2010 were extracted from registries. Compared to men, women were older (mean age 56 ± 12 vs 67 ± 10 years, p <0.001), and female gender was associated with a higher frequency of co-morbidities, including hypertension, diabetes, and dyslipidemia. Women had longer pain-to-door time and more severe hemodynamic status than men. All-cause mortality rates were 13.6% in women and 7.0% in men at 1 year after the index admission (hazard ratio for women 2.01, 95% confidence interval 1.80 to 2.25, p <0.001). The risk for death after ST-segment elevation myocardial infarction corresponded highly with age. Although the risk remained high after adjusting for age, further analyses adjusting for medical history, clinical performance, and hemodynamic status diminished the gender effect (hazard ratio 1.00, 95% confidence interval 0.86 to 1.17, p = 0.821). Propensity score matching, as a sensitivity analysis, corroborated the results. In conclusion, this study shows that women have a comparable risk for death after ST-segment elevation myocardial infarction as men. The gender effect was accounted for mostly by the women's older age, complex co-morbidities, and severe hemodynamic conditions at presentation.

AB - There has been controversy over the disparity between men and women with regard to the management and prognosis of acute myocardial infarction. Analyzing nationwide multicenter prospective registries in Korea, the aim of this study was to determine whether female gender independently imposes a risk for mortality. Data from 14,253 patients who were hospitalized for ST-segment elevation myocardial infarction from November 2005 to September 2010 were extracted from registries. Compared to men, women were older (mean age 56 ± 12 vs 67 ± 10 years, p <0.001), and female gender was associated with a higher frequency of co-morbidities, including hypertension, diabetes, and dyslipidemia. Women had longer pain-to-door time and more severe hemodynamic status than men. All-cause mortality rates were 13.6% in women and 7.0% in men at 1 year after the index admission (hazard ratio for women 2.01, 95% confidence interval 1.80 to 2.25, p <0.001). The risk for death after ST-segment elevation myocardial infarction corresponded highly with age. Although the risk remained high after adjusting for age, further analyses adjusting for medical history, clinical performance, and hemodynamic status diminished the gender effect (hazard ratio 1.00, 95% confidence interval 0.86 to 1.17, p = 0.821). Propensity score matching, as a sensitivity analysis, corroborated the results. In conclusion, this study shows that women have a comparable risk for death after ST-segment elevation myocardial infarction as men. The gender effect was accounted for mostly by the women's older age, complex co-morbidities, and severe hemodynamic conditions at presentation.

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