Abstract 15010: Women Have Better Long-Term Prognosis After Myocardial Infarction Regardless of Less Aggressive Treatment - Results From a Nationwide Cohort in Finland
Introduction: The aim of this study was to describe sex differences in prognosis and risk of subsequent cardiovascular events after myocardial infarction (MI), with a focus on patients surviving more than one year without subsequent MI or stroke.
Methods: This observational study linking patient-level data from different nationwide registers included patients discharged from hospitals after MI in Finland in 2009-2012. Patients ≥ 18 years of age surviving 7 days after the index MI were included. Primary end points were re-infarction, stroke, cardiovascular mortality and overall mortality. The patients were followed until the end of 2013.
Results: The study cohort consisted of 35,238 MI patients (60% men), of whom 67% were hospitalized due to NSTEMI. PCI was performed in 36% of all patients (in 46% of patients < 80 years old and in 16% of patients ≥ 80 years old). When stratifying by sex, 43% of the men and 25% of the women underwent PCI. After adjustments, women were significantly less likely to undergo PCI compared to men (OR 0.73; 95% CI 0.70-0.77; P < 0.001). Overall, 27,188 (77%) patients survived 12 months without subsequent MI or stroke. The mean age was 72 years both in the whole cohort at baseline and in survivors at one year of the follow-up. The risk of having an outcome event increased with age and was highest beyond the first year of follow-up in elderly patients (Table 1). STEMI as index event compared to NSTEMI was less likely to receive an outcome event, with the exception of stroke. Women had significantly lower overall mortality hazard compared to men after adjustments both during the first 12 months after MI and beyond. Sex differences in hazard of subsequent MI or stroke were minor.
Conclusions: Independently from age and MI type, women were 27% less likely to be treated with PCI than men. Risk of MI, stroke, cardiovascular mortality and overall mortality increases with age. Women appear to have better long-term survival after MI than men, regardless of less intensive treatment.
Author Disclosures: V. Kytö: None. T. Prami: None. H. Khanfir: None. A. Deleskog: None. P. Hasvold: None. E. Reissell: None. J. Airaksinen: None.
- © 2016 by American Heart Association, Inc.