The impact of sex differences on 3-year outcomes of patients with non-ST-segment elevation myocardial infarction after successful stent implantation according to symptom-to-balloon time

Yong Hoon Kim, Ae Young Her, Seung Woon Rha, Cheol Ung Choi, Byoung Geol Choi, Soohyung Park, Dong Oh Kang, Jung Rae Cho, Ji Young Park, Sang Ho Park, Myung Ho Jeong

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Because no data are available, we compared the 3-year outcomes of patients with non-ST-elevation myocardial infarction (NSTEMI) based on sex and symptom-to-balloon time (SBT). Methods: This study included 4910 patients who were divided into two groups based on SBT: SBT <48 h (n = 3,293, 67.1%) and SBT ≥48 h (n = 1,617, 32.9%). The primary outcome was all-cause death during the 3-year follow-up period. The secondary outcome was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction, or repeat coronary revascularization. Results: After adjustment, the in-hospital mortality rates for males and females in the SBT <48 h and SBT ≥48 h groups were similar. During a 3-year follow-up period, females in the SBT <48 h group had significantly higher rates of all-cause death (adjusted hazard ratio [aHR], 1.482; P = 0.006), cardiac death (CD, aHR, 1.617; P = 0.009), and MACE (aHR, 1.268; P = 0.024) than those males in the same groups. Females and males in the SBT ≥48 h group did not differ significantly in the primary and secondary outcomes. In males, the rates of all-cause death (P = 0.008) and CD (P = 0.024) were significantly higher in the SBT ≥48 h group than in the SBT <48 h group. Conclusions: This study has identified a higher 3-year mortality rate in female patients with NSTEMI and SBT <48 h compared to their male counterparts. As such, a more preventive approach may be required to reduce mortality in these female patients.

Original languageEnglish
JournalHellenic Journal of Cardiology
DOIs
Publication statusAccepted/In press - 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 Hellenic Society of Cardiology

Keywords

  • Mortality
  • Non-ST Elevated Myocardial Infarction
  • Percutaneous Coronary Intervention
  • Sex Factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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