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Gender differences in risk factors and clinical outcomes in young patients with acute myocardial infarction
  1. Kyoung Im Cho1,
  2. Eun-Seok Shin2,
  3. Soe Hee Ann2,
  4. Scot Garg3,
  5. Ae-Young Her4,
  6. Jeong Su Kim5,
  7. Jun Hee Han6,
  8. Myung Ho Jeong7
  9. on behalf of the KAMIR Registry
  1. 1Department of Cardiology, Kosin University School of Medicine, Busan, South Korea
  2. 2Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
  3. 3East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, UK
  4. 4Division of Cardiology, Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea
  5. 5Department of Cardiology, Pusan National University School of Medicine, Yangsan, South Korea
  6. 6Division of Biostatistics, Research Institute of Convergence for Biomedical Science and Technology, Pusan National University School of Medicine, Yangsan, South Korea
  7. 7The Heart Center of Chonnam National University Hospital, Gwangju, South Korea
  1. Correspondence to Dr Eun-Seok Shin, Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan 44033, South Korea; sesim1989{at}gmail.com

Abstract

Background There are limited data on the influence of gender on risk factors and clinical outcomes in young patients with acute myocardial infarction (AMI).

Methods This prospective study stratified outcomes according to gender in patients of age ≤50 years with a diagnosis of AMI, and who were enrolled in the nationwide registry of the Korea Working Group of Myocardial Infarction. The end point was the incidence of major adverse cardiovascular events (MACEs) defined as the composite of cardiac death, recurrent myocardial infarction (MI), and repeat revascularisation at 30 days and 1 year after admission.

Results The registry enrolled 30 001 patients with AMI, of whom 5200 met the study inclusion criteria; 4805 patients were male and 395 were female. Current smoking was significantly higher in men, while hypertension and diabetes mellitus were significantly more common in women. Women underwent less coronary revascularisation, and were less likely to be on optimal medical therapy compared with men despite having a higher Killip class at presentation and higher risk angiographic findings. Although women had higher rates of MACEs (3.8% vs 1.8%, p=0.018 at 30 days and 7.8% vs 4.7%, p=0.004 at 1-year follow-up) compared with men, female gender was not an independent predictor of MACEs after adjusting for propensity score.

Conclusions There were significant gender differences in the risk factors for coronary artery disease and the short-term and long-term clinical outcomes of young patients with AMI. Continued preventive strategies should be focused on gender-different risk factor reduction in these young patients.

  • GENDER
  • CHD/CORONORARY HEART
  • Clinical epidemiology
  • Outcome Research Evaluation

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