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首页> 外文期刊>The American Journal of Cardiology >Comparison of Late Cardiac Death and Myocardial Infarction Rates in Women Vs Men With ST-Elevation Myocardial Infarction
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Comparison of Late Cardiac Death and Myocardial Infarction Rates in Women Vs Men With ST-Elevation Myocardial Infarction

机译：妇女晚期心脏死亡和心肌梗死率的比较与ST升高心肌梗死的男性

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Women and patients with incomplete revascularization (IR) have a worse prognosis after ST elevation myocardial infarction (STEMI). However, the extent to which IR affects outcomes for women with STEMI compared with men is not well characterized. Thus, we examined late outcomes of 589 consecutive STEMI patients who received percutaneous coronary intervention and assessed SYNTAX scores (SS), both at baseline and after all procedures (residual SS). A residual SS >8 defined IR. The primary end point was cardiac death or myocardial infarction (MI), with median follow-up of 3.6 years [interquartile range [IQR] 2.6 to 4.7]. Women (n = 123) had lower baseline SSs 15.0 [IQR 9 to 20], than men (n = 466), 16.0 [IQR 9 to 20; p = 0.02. After all planned procedures, the residual SS was 5.0 [IQR 0 to 9] in women and 5.0 (IQR 1 to 11] in men, p = 0.37. Cardiac death or MI occurred in (97/589) patients (16%), 24% (30/123) in women and 14% (67/466) in men (hazard ratio [HR] 1.75; 95% confidence intervals [CI] 1.14 to 2.69; p = 0.01). In patients with residual SYNTAX score (rSS) >8 cardiac death or MI occurred in 43% (15/35) of women and 23% 36/158 men (HR 2.14; 95% CI 1.17 to 3.91; p = 0.01). In patients with rSS = 0 to 8 cardiac death or MI occurred in 17% (15/88) of women and 10% of men (31/308) (HR 1.68; 95% CI 0.91 to 3.12; p = 0.10; interaction p value 0.58). Multivariate analysis found women were 1.77 times more likely than men to experience cardiac death or MI (95% CI 1.13 to 2.77; p = 0.01). In conclusion, we found despite a lower burden of disease at presentation and no difference in rates of IR between men and women, outcome differences were substantial. Women with rSS >8 were twice as likely as men with the same rSS to experience cardiac death or MI post-STEMI. Differences remained significant postrisk adjustment. (C) 2020 Elsevier Inc. All rights reserved.
机译：女性和不完全血运重建（IR）患者在ST段抬高心肌梗死（STEMI）后的预后较差。然而，与男性相比，IR对女性ST段抬高型心肌梗死患者预后的影响程度尚不明确。因此，我们研究了589名连续接受经皮冠状动脉介入治疗的STEMI患者的晚期预后，并评估了基线检查和所有手术后的SYNTAX评分（SS）。残余SS>8定义IR。主要终点为心脏死亡或心肌梗死（MI），中位随访时间为3.6年[四分位区间[IQR]2.6至4.7]。女性（n=123）的基线SSs为15.0[IQR 9至20]，低于男性（n=466），16.0[IQR 9至20；p=0.02。在所有计划的手术后，女性的残余SSs为5.0[IQR 0至9]，男性为5.0（IQR 1至11]，p=0.37。心脏死亡或心肌梗死发生在（97/589）患者（16%），女性为24%（30/123），男性为14%（67/466）（危险比[HR]1.75；95%可信区间[CI]1.14至2.69；p=0.01）。在剩余语法评分（rSS）>8的患者中，43%（15/35）的女性和23%（36/158）的男性发生心脏死亡或心肌梗死（HR 2.14；95%可信区间1.17至3.91；p=0.01）。在rSS=0至8的患者中，17%（15/88）的女性和10%的男性（31/308）发生心脏死亡或心肌梗死（HR 1.68；95%可信区间0.91至3.12；p=0.10；交互作用p值0.58）。多变量分析发现，女性发生心源性死亡或心肌梗死的可能性是男性的1.77倍（95%可信区间1.13至2.77；p=0.01）。总之，我们发现，尽管在发病时疾病负担较低，而且男女之间的IR发生率没有差异，但结果差异很大。rSS>8的女性发生心脏死亡或ST段抬高型心肌梗死后心肌梗死的可能性是相同rSS的男性的两倍。风险调整后仍存在显著差异。（C） 2020爱思唯尔公司版权所有。

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