Gender differences in clinical characteristics and in-hospital and one-year outcomes of young patients with ST-segment elevation myocardial infarction under the age of 40

Abstract

Introduction: Although the incidence of acute ST-segment elevation myocardial infarction (STEMI) in the elderly population has decreased in recent years, this is not the case for young people. At the same time, no reduction in hospitalization rate after STEMI was shown in young people. Clinical characteristics, risk factors, angiographic findings, in-hospital and one-year outcomes of patients under the age of 40 and their gender differences were investigated. Methods: This study has been performed retrospectively in two centers. Between January 2015 and April 2019, 212 patients aged 18-40 years with STEMI and who underwent reperfusion therapy were included. The gender differences were compared. Results: The median age of (male 176; 83.0% and female 36; 17.0%) patients included in the study was 36 (33-38) for men and 36 (34-38) for women. Chest pain was the most common complaint for both genders (96.0% vs. 94.4%; P = 0.651). While men presented more often with Killip class 1,women presented more often with Killip class 2. The anterior myocardial infarction (MI) was the most common MI type and it was higher in women than in man (P = 0.027). At one year of follow-up, the prevalence of all-cause hospitalization was 24%, MI 3.8%, coronary angiography 15.1%, cardiovascular death 1.4%, and all-cause death 0.47%, there was no gender difference. Conclusion: Anterior MI was the most common type of MI and it was more common in women than in men. Left anterior descending artery was the most common involved coronary artery. The most common risk factor is smoking. In terms of in-hospital outcome, left ventricular ejection fraction was significantly lower in women. There was no significant difference in one-year outcomes between both genders.

Impact of Female Gender on Acute and Mid-Term Mortality in Patients with ST-Segment Elevation Myocardial Infarction during the Pandemic Era

“…This difference decreased after the age of 60 and disappeared in older age groups [38]. On the other hand, one ad hoc study, which enrolled a total of 212 young STEMI patients (aged between 18 and 40) treated with pPCI between 2015 and 2019, showed a similar mortality rate both at short-term and at 1-year follow up [39]. All these findings underline that several controversies regarding the impact of gender in the STEMI setting are still present, probably due to several biases in the available studies.…”

293 Impact of Female Gender on Acute and Mid-Term Mortality in Patients With St-Segment Elevation Myocardial Infarction During the Pandemic Era

“…This difference decreased after the age of 60 and disappeared in older age groups [38]. On the other hand, one ad hoc study, which enrolled a total of 212 young STEMI patients (aged between 18 and 40) treated with pPCI between 2015 and 2019, showed a similar mortality rate both at short-term and at 1-year follow up [39]. All these findings underline that several controversies regarding the impact of gender in the STEMI setting are still present, probably due to several biases in the available studies.…”