Left ventricular remodelling after ST-segment elevation myocardial infarction: sex differences and prognosis
Pieter van der Bijl1,2, Rachid Abou1, Laurien Goedemans1
1Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands.
ESC Heart Failure
|February 15, 2020
Summary
Left ventricular remodelling after ST-segment elevation myocardial infarction (STEMI) is common. This study found that LV remodelling and long-term survival were similar in men and women treated with primary percutaneous coronary intervention.
Area of Science:
- Cardiology
- Cardiovascular Research
- Clinical Medicine
Background:
- Left ventricular (LV) remodelling post-STEMI negatively impacts patient outcomes.
- The influence of sex on LV remodelling after STEMI remains unclear.
Purpose of the Study:
- To investigate sex differences in LV remodelling incidence and long-term prognosis after STEMI.
- To evaluate LV remodelling in the context of modern primary percutaneous coronary intervention (PCI) and pharmacotherapy.
Main Methods:
- Analysis of data from a primary PCI STEMI registry.
- LV remodelling defined as ≥20% increase in LV end-diastolic volume at 3, 6, or 12 months post-infarct.
- Long-term survival evaluated using log-rank tests.
Main Results:
- 1995 STEMI patients analyzed (77% men, 23% women).
- LV remodelling occurred in 48% of patients, with equal frequency in men and women.
- No significant difference in long-term survival between remodellers and non-remodellers was observed in either sex.
Conclusions:
- LV post-infarct remodelling incidence is similar between men and women.
- Long-term survival for LV remodellers and non-remodellers does not differ by sex.
- These findings apply to patients treated with primary PCI and optimal pharmacotherapy post-STEMI.
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