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Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis
Background: Coronary artery disease (CAD) is the most frequent cause of ST-segment elevation myocardial infarction (STEMI). Etiopathogenic and prognostic characteristics in young patients may differ from older patients and young women may present worse outcomes than men. We aimed to evaluate the cli...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8004961/ https://www.ncbi.nlm.nih.gov/pubmed/33806738 http://dx.doi.org/10.3390/jcm10061314 |
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author | Lorca, Rebeca Pascual, Isaac Aparicio, Andrea Junco-Vicente, Alejandro Alvarez-Velasco, Rut Barja, Noemi Roces, Luis Suárez-Cuervo, Alfonso Diaz, Rocio Moris, Cesar Hernandez-Vaquero, Daniel Avanzas, Pablo |
author_facet | Lorca, Rebeca Pascual, Isaac Aparicio, Andrea Junco-Vicente, Alejandro Alvarez-Velasco, Rut Barja, Noemi Roces, Luis Suárez-Cuervo, Alfonso Diaz, Rocio Moris, Cesar Hernandez-Vaquero, Daniel Avanzas, Pablo |
author_sort | Lorca, Rebeca |
collection | PubMed |
description | Background: Coronary artery disease (CAD) is the most frequent cause of ST-segment elevation myocardial infarction (STEMI). Etiopathogenic and prognostic characteristics in young patients may differ from older patients and young women may present worse outcomes than men. We aimed to evaluate the clinical characteristics and prognosis of men and women with premature STEMI. Methods: A total 1404 consecutive patients were referred to our institution for emergency cardiac catheterization due to STEMI suspicion (1 January 2014–31 December 2018). Patients with confirmed premature (<55 years old in men and <60 in women) STEMI (366 patients, 83% men and 17% women) were included (359 atherothrombotic and 7 spontaneous coronary artery dissection (SCAD)). Results: Premature STEMI patients had a high prevalence of classical cardiovascular risk factors. Mean follow-up was 4.1 years (±1.75 SD). Mortality rates, re-hospitalization, and hospital stay showed no significant differences between sexes. More than 10% of women with premature STEMI suffered SCAD. There were no significant differences between sexes, neither among cholesterol levels nor in hypolipemiant therapy. The global survival rates were similar to that expected in the general population of the same sex and age in our region with a significantly higher excess of mortality at 6 years among men compared with the general population. Conclusion: Our results showed a high incidence of cardiovascular risk factors, a high prevalence of SCAD among young women, and a generally good prognosis after standardized treatment. During follow-up, 23% suffered a major cardiovascular event (MACE), without significant differences between sexes and observed survival at 1, 3, and 6 years of follow-up was 96.57% (95% CI 94.04–98.04), 95.64% (95% CI 92.87–97.35), and 94.5% (95% CI 91.12–97.66). An extra effort to prevent/delay STEMI should be invested focusing on smoking avoidance and optimal hypolipemiant treatment both in primary and secondary prevention. |
format | Online Article Text |
id | pubmed-8004961 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-80049612021-03-29 Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis Lorca, Rebeca Pascual, Isaac Aparicio, Andrea Junco-Vicente, Alejandro Alvarez-Velasco, Rut Barja, Noemi Roces, Luis Suárez-Cuervo, Alfonso Diaz, Rocio Moris, Cesar Hernandez-Vaquero, Daniel Avanzas, Pablo J Clin Med Article Background: Coronary artery disease (CAD) is the most frequent cause of ST-segment elevation myocardial infarction (STEMI). Etiopathogenic and prognostic characteristics in young patients may differ from older patients and young women may present worse outcomes than men. We aimed to evaluate the clinical characteristics and prognosis of men and women with premature STEMI. Methods: A total 1404 consecutive patients were referred to our institution for emergency cardiac catheterization due to STEMI suspicion (1 January 2014–31 December 2018). Patients with confirmed premature (<55 years old in men and <60 in women) STEMI (366 patients, 83% men and 17% women) were included (359 atherothrombotic and 7 spontaneous coronary artery dissection (SCAD)). Results: Premature STEMI patients had a high prevalence of classical cardiovascular risk factors. Mean follow-up was 4.1 years (±1.75 SD). Mortality rates, re-hospitalization, and hospital stay showed no significant differences between sexes. More than 10% of women with premature STEMI suffered SCAD. There were no significant differences between sexes, neither among cholesterol levels nor in hypolipemiant therapy. The global survival rates were similar to that expected in the general population of the same sex and age in our region with a significantly higher excess of mortality at 6 years among men compared with the general population. Conclusion: Our results showed a high incidence of cardiovascular risk factors, a high prevalence of SCAD among young women, and a generally good prognosis after standardized treatment. During follow-up, 23% suffered a major cardiovascular event (MACE), without significant differences between sexes and observed survival at 1, 3, and 6 years of follow-up was 96.57% (95% CI 94.04–98.04), 95.64% (95% CI 92.87–97.35), and 94.5% (95% CI 91.12–97.66). An extra effort to prevent/delay STEMI should be invested focusing on smoking avoidance and optimal hypolipemiant treatment both in primary and secondary prevention. MDPI 2021-03-23 /pmc/articles/PMC8004961/ /pubmed/33806738 http://dx.doi.org/10.3390/jcm10061314 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Lorca, Rebeca Pascual, Isaac Aparicio, Andrea Junco-Vicente, Alejandro Alvarez-Velasco, Rut Barja, Noemi Roces, Luis Suárez-Cuervo, Alfonso Diaz, Rocio Moris, Cesar Hernandez-Vaquero, Daniel Avanzas, Pablo Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis |
title | Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis |
title_full | Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis |
title_fullStr | Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis |
title_full_unstemmed | Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis |
title_short | Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis |
title_sort | premature stemi in men and women: current clinical features and improvements in management and prognosis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8004961/ https://www.ncbi.nlm.nih.gov/pubmed/33806738 http://dx.doi.org/10.3390/jcm10061314 |
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