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Sex-Related Differences in Thrombus Burden in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention

Maria Virginia Manzi1, Sergio Buccheri2, Sanjit S Jolly3

  • 1Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden; Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.

JACC. Cardiovascular Interventions
|October 20, 2022
PubMed

Insights

Women with high thrombus burden (HTB) after ST-segment elevation myocardial infarction (STEMI) face worse outcomes. This includes increased risks for cardiovascular death and stent thrombosis compared to men with HTB.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Sex-based Medicine

Background:

  • Women exhibit poorer prognoses post-ST-segment elevation myocardial infarction (STEMI) compared to men.
  • The influence of thrombus burden (TB) on these sex-specific outcome disparities in STEMI patients remains underexplored.

Purpose of the Study:

  • To investigate sex-based differences in thrombus burden (TB) among STEMI patients.
  • To evaluate the clinical implications of TB on sex-related outcomes in STEMI.

Main Methods:

  • Analysis of individual patient data from three major randomized trials on manual thrombus aspiration.
  • Inclusion of 19,047 STEMI patients (76.1% men, 23.9% women).
  • Primary endpoint: 1-year cardiovascular death; secondary endpoints: recurrent MI, heart failure, all-cause mortality, stroke, stent thrombosis, and target vessel revascularization.

Main Results:

  • High thrombus burden (HTB) is linked to worse 1-year outcomes, including increased cardiovascular death risk.
  • Female sex was associated with higher 1-year cardiovascular death risk, particularly in patients with HTB.
  • Women with HTB showed increased risks for stent thrombosis and all-cause mortality compared to men.

Conclusions:

  • Angiographic evidence of HTB significantly worsens prognosis in STEMI patients.
  • Among STEMI patients with HTB, women experience higher risks of stent thrombosis, cardiovascular death, and all-cause mortality than men.
  • Further research is needed to elucidate the mechanisms behind the excess mortality in women with STEMI and HTB.
Abstract

Keywords:
ST-segment elevation myocardial infarctionTAPASTASTETIMI thrombus burdenTOTALwomen

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