Antithrombotic Management and Outcomes of Anterior ST-Elevation Myocardial Infarction With New-Onset Wall Motion...

Area of Science:

• Cardiology
• Clinical Research
• Sex Differences in Medicine

Background:

• Anterior ST-elevation myocardial infarction (STEMI) can lead to antero-apical wall motion abnormalities (WMAs).
• The risk of left ventricular thrombus formation is a concern in these patients.
• Existing research has not clarified potential sex-based differences in prophylaxis and outcomes for STEMI patients with WMAs.

Purpose of the Study:

• To investigate if prophylaxis rates for left ventricular thrombus differ between men and women with anterior STEMI and new-onset antero-apical WMAs.
• To compare clinical outcomes at 6 months between men and women following anterior STEMI with WMAs.
• To assess sex-based disparities in the management and prognosis of this patient cohort.

Main Methods:

• A multicentre retrospective cohort study was performed on patients with STEMI and antero-apical WMAs treated with primary percutaneous coronary intervention.
• Patients with prior oral anticoagulation use were excluded from the analysis.
• Triple therapy rates at discharge and net adverse clinical events at 6 months were compared between sexes using multivariate logistic regression.

Main Results:

• The study included 1664 patients (24.2% women).
• Triple therapy prescription at discharge was similar between women (34.3%) and men (38.7%).
• At 6 months, net adverse clinical events occurred in 8.2% of women and 7.6% of men, with no significant difference after adjustment.

Conclusions:

• Rates of oral anticoagulation prescription for left ventricular thrombus prophylaxis were similar in women and men.
• Clinical outcomes at 6 months were comparable between sexes following anterior STEMI with new-onset antero-apical WMAs.
• No significant sex-based differences were observed in the risk of bleeding or ischemic events.