BACKGROUND: Survival after ST-elevation myocardial infarction (STEMI) as a first event in Germany was analyzed. METHODS: Adults with a first-event STEMI were included for analysis on the basis of insurance data from a German health insurance provider (AOK; approximately 26 million members; median follow-up 48.5 months). The primary endpoints were 30-day mortality, reinfarction or death, major adverse cardiovascular and cerebro - vascular events (MACCE), long-term survival for more than 90 days, and overall survival (OS). RESULTS: STEMI occurred in 17 444 patients (32.8% women). The women were older than the men (median age 74 versus 60 years) and suffered more frequently from cardiovascular comorbidities such as diabetes mellitus, chronic renal disease, and arterial hypertension. Women underwent endovascular or surgical treatment less frequently, but sustained complications (cardiogenic shock, resuscitation) more frequently. After adjustment of the data, women were at higher risk of 30-day mortality (odds ratio [OR] 1.17, 95% confidence interval [95% CI] [1.07; 1.28]), reinfarction or death (hazard ratio [HR] 1.09, 95% CI [1.04; 1.16]), MACCE (HR 1.09, 95% CI [1.04; 1.15]), and poorer OS (HR 1.10, 95% CI [1.04; 1.17]). This effect was especially pronounced in women aged ≤ 60 years. No differences between the sexes were seen among patients who survived for 90 days after the infarction. CONCLUSION: In Germany, women ≤ 60 years display a higher 30-day mortality after first-event STEMI, which affects their overall survival. Younger women should receive intensified medical attention after STEMI, especially in the early phase.
BACKGROUND: Survival after ST-elevation myocardial infarction (STEMI) as a first event in Germany was analyzed. METHODS: Adults with a first-event STEMI were included for analysis on the basis of insurance data from a German health insurance provider (AOK; approximately 26 million members; median follow-up 48.5 months). The primary endpoints were 30-day mortality, reinfarction or death, major adverse cardiovascular and cerebro - vascular events (MACCE), long-term survival for more than 90 days, and overall survival (OS). RESULTS: STEMI occurred in 17 444 patients (32.8% women). The women were older than the men (median age 74 versus 60 years) and suffered more frequently from cardiovascular comorbidities such as diabetes mellitus, chronic renal disease, and arterial hypertension. Women underwent endovascular or surgical treatment less frequently, but sustained complications (cardiogenic shock, resuscitation) more frequently. After adjustment of the data, women were at higher risk of 30-day mortality (odds ratio [OR] 1.17, 95% confidence interval [95% CI] [1.07; 1.28]), reinfarction or death (hazard ratio [HR] 1.09, 95% CI [1.04; 1.16]), MACCE (HR 1.09, 95% CI [1.04; 1.15]), and poorer OS (HR 1.10, 95% CI [1.04; 1.17]). This effect was especially pronounced in women aged ≤ 60 years. No differences between the sexes were seen among patients who survived for 90 days after the infarction. CONCLUSION: In Germany, women ≤ 60 years display a higher 30-day mortality after first-event STEMI, which affects their overall survival. Younger women should receive intensified medical attention after STEMI, especially in the early phase.
Authors: Vera Regitz-Zagrosek; Sabine Oertelt-Prigione; Eva Prescott; Flavia Franconi; Eva Gerdts; Anna Foryst-Ludwig; Angela H E M Maas; Alexandra Kautzky-Willer; Dorit Knappe-Wegner; Ulrich Kintscher; Karl Heinz Ladwig; Karin Schenck-Gustafsson; Verena Stangl Journal: Eur Heart J Date: 2015-11-03 Impact factor: 29.983
Authors: David D McManus; Joel Gore; Jorge Yarzebski; Frederick Spencer; Darleen Lessard; Robert J Goldberg Journal: Am J Med Date: 2011-01 Impact factor: 4.965
Authors: Raffaele Bugiardini; Andrew T Yan; Raymond T Yan; David Fitchett; Anatoly Langer; Olivia Manfrini; Shaun G Goodman Journal: Eur Heart J Date: 2011-03-07 Impact factor: 29.983
Authors: Borja Ibanez; Stefan James; Stefan Agewall; Manuel J Antunes; Chiara Bucciarelli-Ducci; Héctor Bueno; Alida L P Caforio; Filippo Crea; John A Goudevenos; Sigrun Halvorsen; Gerhard Hindricks; Adnan Kastrati; Mattie J Lenzen; Eva Prescott; Marco Roffi; Marco Valgimigli; Christoph Varenhorst; Pascal Vranckx; Petr Widimský Journal: Eur Heart J Date: 2018-01-07 Impact factor: 29.983
Authors: Ioanna Kosmidou; Björn Redfors; Harry P Selker; Holger Thiele; Manesh R Patel; James E Udelson; E Magnus Ohman; Ingo Eitel; Christopher B Granger; Akiko Maehara; Ajay Kirtane; Philippe Généreux; Paul L Jenkins; Ori Ben-Yehuda; Gary S Mintz; Gregg W Stone Journal: Eur Heart J Date: 2017-06-01 Impact factor: 29.983