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Published on: April 17, 2021
Gender differences in mortality after acute myocardial infarction with mild to moderate heart failure
Yuval Konstantino1, Elvira Chen, David Hasdai
1Cardiology Department, Rabin Medical Center, Beilinmson Campus, Jabotinsky St., Petah-Tikva 49100, Israel. yuvkon@gmail.com
Insights
Women with heart failure after acute myocardial infarction have higher crude mortality rates than men. However, after accounting for risk factors and treatment, the difference in prognosis between genders disappears, suggesting targeted interventions are needed.
Area of Science:
- Cardiology
- Clinical Medicine
- Public Health
Background:
- Heart failure (HF) significantly worsens outcomes following acute myocardial infarction (AMI).
- Women exhibit higher mortality rates post-AMI compared to men, but their prognosis with co-existing HF remains unclear.
Purpose of the Study:
- To compare the prognosis of men and women diagnosed with acute myocardial infarction (AMI) and mild-to-moderate heart failure (HF).
Main Methods:
- Analysis of data from 3456 consecutive patients hospitalized with AMI across Israeli cardiac care units.
- Inclusion criteria: patients with AMI and HF upon admission.
Main Results:
- Women with AMI and HF were older and had more risk factors than men.
- Women received less percutaneous coronary angiography/intervention.
- Crude mortality rates at 7 days, 30 days, and 1 year were higher in women, but adjusted rates showed no significant gender difference.
Conclusions:
- Higher crude mortality in women with AMI and HF is linked to increased risk factors and reduced revascularization/medical therapy rates.
- Women with AMI and HF represent a high-risk subgroup requiring closer monitoring.
- Further research is needed to determine if intensified management can improve outcomes for this group.
Background:
Heart failure (HF) is associated with poor outcome after acute myocardial infarction (AMI). Women have higher mortality rate than men after AMI, however, it is unknown whether women with HF after AMI have different prognosis than men.
Aim:
To compare the prognosis of men and women with AMI and mild-moderate HF.
Methods:
We analyzed data of 3456 consecutive patients with AMI hospitalized in all cardiac care units in Israel during two nationwide surveys.
Results:
Among patients with AMI and HF on admission: women were older, had more risk factors, and were less likely to undergo percutaneous coronary angiography/intervention. Women with HF had higher (7-days, 30-days, and 1-year) crude mortality rates than men. However, adjusted mortality rates were not significantly different between genders.
Conclusions:
Women with AMI complicated by HF had higher crude mortality rate than men that was eliminated after multivariate analysis, suggesting that the higher mortality rate may be attributed to increased prevalence of risk factors and lower rate of revascularization and medical therapies among women. Women with AMI and HF should be considered as a high-risk subgroup with adverse outcome. It remains to be determined whether more intensive management will improve their prognosis.
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