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Gender-related differences in thrombogenic factors predicting recurrent cardiac events in patients after acute

V G Kalaria1, W Zareba, A J Moss

  • 1Cardiology Unit, University of Rochester Medical Center, Rochester, NY 14642, USA.

The American Journal of Cardiology
|June 17, 2000
PubMed

Insights

Gender influences the risk of recurrent cardiac events after acute myocardial infarction. Elevated factor VIIa predicts events in women, while D-dimer is more predictive in men, suggesting different underlying mechanisms.

Area of Science:

  • Cardiovascular Medicine
  • Thrombosis Research
  • Gender-Specific Medicine

Background:

  • Thrombosis is a key factor in recurrent coronary events post-acute myocardial infarction (AMI).
  • The prognostic impact of thrombogenic factors, stratified by gender, remains largely unknown in this patient population.

Purpose of the Study:

  • To investigate gender-specific differences in the prognostic significance of thrombogenic factors for predicting cardiac events in patients following AMI.

Main Methods:

  • Measured blood levels of 12 thrombogenic and lipid factors in 791 men and 254 women 2 months post-AMI.
  • Utilized multivariate Cox regression analysis to assess the association between factor levels and cardiac events over a mean 26-month follow-up.

Main Results:

  • Factor VIIa levels were significantly higher in women and predicted cardiac events in women (HR 2.80, p=0.022) but not men (HR 0.92, p=0.80).
  • D-dimer showed prognostic value in men (p=0.006) but not women (p=0.36), with a trend towards greater predictive value in men (HR 2.35 vs 1.58).
  • Elevated apolipoprotein A, HDL cholesterol, fibrinogen, and factor VIIa were observed in postinfarction women compared to men.

Conclusions:

  • Elevated factor VIIa is an independent predictor of recurrent cardiac events in women post-AMI.
  • D-dimer appears more predictive of cardiac events in men post-AMI.
  • These findings suggest distinct gender-related pathophysiological mechanisms underlying recurrent cardiac events after myocardial infarction.

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