Coronary artery disease in women usually develops 10 years later than in men, and some evidence suggests women have higher mortality, especially when it comes to ST elevation MI (STEMI). Registries have shown higher mortality both in hospital and at one year follow up.
In part, this difference is observed because of the gap in therapy access, such as angiography studies or PCI procedures during an acute coronary syndrome.
The aim of this study was to analyze the impact of gender in 10-year outcomes of STEMI patients treated with percutaneous coronary intervention (PCI) in the EXAMINATION-EXTEND study (use of XIENCE stent in STEMI).
Study outcomes were a patient oriented combined end point (POCE) which included all-cause mortality, any MI or revascularization at 10 years.
Data from 1498 patients were obtained, 254 women (17%). Women were generally older, fewer smoked and they had more hypertension.
At 10-year follow-up, we observed the presence of POCE in 40.6% of women and 34.2% of men (adjusted HR, 1.14, CI 95% 0.91-1.42; P=0.259), with a tendency towards higher all-cause mortality in women (adjusted HR: 1.30, CI 95% 0.99-1.71; P=0.063). However, cardiovascular death did not vary between the groups.
Read also: RADIANCE-HTN SOLO: Control Durability of BP
At multivariable analysis, only age (HR: 1.06, CI 95% 1.04-1.09; P<0.001) and hypertension (HR: 1.93, CI 95% 1.07-3.51; P=0.030) were independent predictors of POCE.
Conclusions
At 10-year follow-up of ACS patients, we saw women with STEMI did not have a worse prognosis as regards 10-year POCE, compared against men. Although there was a tendency toward higher mortality, there was no difference when it came to cardiac mortality.
Being able to look at 10-year data offers a great opportunity for gender based long term risk assessment. There is a sample limitation of only 17% of women, which means these conclusions will only serve as hypotheses generator.
Dr. Omar Tupayachi.
Member of the Editorial Board of SOLACI.org.
Original title: Gender Differences in 10-Year Outcomes Following STEMI.
Source: Rader, Florian et al. “Durability of blood pressure reduction after ultrasound renal denervation: three-year follow-up of the treatment arm of the randomised RADIANCE-HTN SOLO trial.” EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, EIJ-D-22-00305. 1 Aug. 2022, doi:10.4244/EIJ-D-22-00305.
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