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Sex Difference in the Case Fatality of Older Myocardial Infarction Patients

BACKGROUND: The female sex is associated with poorer outcomes after myocardial infarction (MI), although current evidence in older patients is limited and mixed. We sought to evaluate sex-based differences in outcome after MI in older patients. METHOD: Consecutive older (≥70 years) all-comer patient...

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Autores principales: Kytö, Ville, Nuotio, Maria, Rautava, Päivi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8893190/
https://www.ncbi.nlm.nih.gov/pubmed/34049387
http://dx.doi.org/10.1093/gerona/glab152
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author Kytö, Ville
Nuotio, Maria
Rautava, Päivi
author_facet Kytö, Ville
Nuotio, Maria
Rautava, Päivi
author_sort Kytö, Ville
collection PubMed
description BACKGROUND: The female sex is associated with poorer outcomes after myocardial infarction (MI), although current evidence in older patients is limited and mixed. We sought to evaluate sex-based differences in outcome after MI in older patients. METHOD: Consecutive older (≥70 years) all-comer patients with out-of-hospital MI admitted to 20 hospitals in Finland between 2005 and 2014 were studied using national registries (n = 40 654, mean age 80 years, 50% women). The outcome of interest was death within 1 year after MI. Differences between sexes (age, baseline features, medication, comorbidities, revascularization, and treating hospital) were balanced by inverse probability weighting. RESULTS: Adjusted all-cause case fatality was lower in women than in men at 30 days (16.0% vs 19.0%, respectively) and at 1 year (27.7% vs 32.4%, respectively) after MI (hazard ratio: 0.83; confidence interval [CI]: 0.80–0.86; p < .0001). Excess 1-year case fatality after MI compared to the corresponding general population was 22.1% (CI: 21.4%–22.8%) in women and 24.1% (CI: 23.4%–24.9%) in men. Women had a lower adjusted hazard of death after MI in subgroups of patients aged 70–79 years and ≥80 years, patients with and without ST elevation MI, revascularized and non-revascularized patients, patients with and without atrial fibrillation, and patients with and without diabetes. The sex difference in case fatality remained similar during the study period. CONCLUSIONS: Older women were found to have a lower hazard of death after an out-of-hospital MI when compared to older men with similar features and treatments. This finding was consistent in several subgroups.
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spelling pubmed-88931902022-03-04 Sex Difference in the Case Fatality of Older Myocardial Infarction Patients Kytö, Ville Nuotio, Maria Rautava, Päivi J Gerontol A Biol Sci Med Sci THE JOURNAL OF GERONTOLOGY: Medical Sciences BACKGROUND: The female sex is associated with poorer outcomes after myocardial infarction (MI), although current evidence in older patients is limited and mixed. We sought to evaluate sex-based differences in outcome after MI in older patients. METHOD: Consecutive older (≥70 years) all-comer patients with out-of-hospital MI admitted to 20 hospitals in Finland between 2005 and 2014 were studied using national registries (n = 40 654, mean age 80 years, 50% women). The outcome of interest was death within 1 year after MI. Differences between sexes (age, baseline features, medication, comorbidities, revascularization, and treating hospital) were balanced by inverse probability weighting. RESULTS: Adjusted all-cause case fatality was lower in women than in men at 30 days (16.0% vs 19.0%, respectively) and at 1 year (27.7% vs 32.4%, respectively) after MI (hazard ratio: 0.83; confidence interval [CI]: 0.80–0.86; p < .0001). Excess 1-year case fatality after MI compared to the corresponding general population was 22.1% (CI: 21.4%–22.8%) in women and 24.1% (CI: 23.4%–24.9%) in men. Women had a lower adjusted hazard of death after MI in subgroups of patients aged 70–79 years and ≥80 years, patients with and without ST elevation MI, revascularized and non-revascularized patients, patients with and without atrial fibrillation, and patients with and without diabetes. The sex difference in case fatality remained similar during the study period. CONCLUSIONS: Older women were found to have a lower hazard of death after an out-of-hospital MI when compared to older men with similar features and treatments. This finding was consistent in several subgroups. Oxford University Press 2021-05-28 /pmc/articles/PMC8893190/ /pubmed/34049387 http://dx.doi.org/10.1093/gerona/glab152 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle THE JOURNAL OF GERONTOLOGY: Medical Sciences
Kytö, Ville
Nuotio, Maria
Rautava, Päivi
Sex Difference in the Case Fatality of Older Myocardial Infarction Patients
title Sex Difference in the Case Fatality of Older Myocardial Infarction Patients
title_full Sex Difference in the Case Fatality of Older Myocardial Infarction Patients
title_fullStr Sex Difference in the Case Fatality of Older Myocardial Infarction Patients
title_full_unstemmed Sex Difference in the Case Fatality of Older Myocardial Infarction Patients
title_short Sex Difference in the Case Fatality of Older Myocardial Infarction Patients
title_sort sex difference in the case fatality of older myocardial infarction patients
topic THE JOURNAL OF GERONTOLOGY: Medical Sciences
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8893190/
https://www.ncbi.nlm.nih.gov/pubmed/34049387
http://dx.doi.org/10.1093/gerona/glab152
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