Left Ventricular Remodelling After St-Segment Elevation Myocardial Infarction: Sex Differences and Prognosis
ESC Heart Failure, vol. 7, pp. 474–481
Abstract
AIMS: Left ventricular (LV) remodelling after ST-segment elevation myocardial infarction (STEMI) worsens outcome. The effect of sex on LV post-infarct remodelling is unknown. We therefore investigated the sex distribution and long-term prognosis of LV post-infarct remodelling after STEMI in the contemporary era of primary percutaneous coronary intervention (PCI) and optimal pharmacotherapy. METHODS AND RESULTS: Data were obtained from an ongoing primary PCI STEMI registry. LV remodelling was defined as ≥20% increase in LV end-diastolic volume at either 3, 6, or 12 months post-infarct, and LV remodelling impact on outcome was evaluated with a log-rank test. A total population of 1995 STEMI patients were analysed (mean age 60 ± 12 years): 1527 (77%) men and 468 (23%) women. The mean age of male patients was 60±11 versus 63±13 years for women (P < 0.001). A total of 953 (48%) patients experienced LV remodelling in the first 12 months of follow-up, and it was equally frequent amongst men (n = 729, 48%) and women (n = 224, 48%). After a median follow-up of 94 (interquartile range 69-119) months, 225 patients died: 171 (11%) men and 54 (12%) women. No survival difference was seen between remodellers and non-remodellers in the male (P = 0.113) and female (P = 0.920) groups. CONCLUSION: LV post-infarct remodelling incidence, as well as long-term survival of LV remodellers and non-remodellers, was similar in men and women who were treated with primary PCI and optimal pharmacotherapy post-STEMI.
Authors 8
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Leiden University · Mayo Clinic · Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre , Leiden ,
Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre , Leiden ,
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre , Leiden ,
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
-
Affiliation as printed
Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
-
Affiliation as printed
Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre , Leiden ,
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre , Leiden ,
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
-
Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre , Leiden ,
Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
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