Sex-based differences in heart failure development during STEMI hospitalization

Area of Science:

• Cardiology
• Clinical Medicine
• Sex Differences in Health

Background:

• Sex-related differences in heart failure (HF) development post-ST-segment elevation myocardial infarction (STEMI) are not well understood.
• This study investigates sex-specific HF incidence in STEMI patients initially classified as Killip class I.
• The impact of in-hospital HF on mortality in this population is also evaluated.

Purpose of the Study:

• To assess sex-specific differences in the development of in-hospital heart failure (HF) among ST-segment elevation myocardial infarction (STEMI) patients.
• To evaluate the impact of in-hospital HF on mortality in STEMI patients admitted in Killip class I.
• To identify factors associated with in-hospital HF development in this cohort.

Main Methods:

• Analysis of prospective, multicenter registry data from six teaching hospitals.
• Primary outcome: development of HF during hospitalization in Killip class I STEMI patients.
• Secondary outcome: in-hospital mortality; multivariable logistic regression used to identify associated factors.

Main Results:

• Among 985 Killip class I STEMI patients, 4.6% developed in-hospital HF, more frequently in women (7.9%) than men (3.6%).
• Female sex (OR 3.09), multivessel disease (OR 2.19), and out-of-hospital cardiac arrest (OR 4.76) were independently associated with HF development.
• Higher left ventricular ejection fraction was protective (OR 0.92); age and final TIMI flow <3 were not associated.

Conclusions:

• Women with STEMI admitted in Killip class I exhibit a significantly higher risk of developing in-hospital heart failure.
• Despite the increased risk of HF development in women, its impact on in-hospital mortality was comparable between sexes.
• These findings highlight the importance of sex-specific considerations in managing STEMI patients at risk for heart failure.