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Sex-Related Differe...
Sex-Related Differences in Thrombus Burden in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention
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- Manzi, Maria Virginia (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
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- Buccheri, Sergio (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Jolly, Sanjit S. (author)
- McMaster University and the Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
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- Zijlstra, Felix (author)
- Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, the Netherlands
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- Fröbert, Ole, 1964- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology, Faculty of Health, Örebro University, Örebro, Sweden
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- Lagerqvist, Bo, 1952- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Mahmoud, Karim D. (author)
- Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, the Netherlands
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- Džavík, Vladimír (author)
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
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- Barbato, Emanuele (author)
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy; Cardiovascular Research Center Aalst, Belgium
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- Sarno, Giovanna (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,kardiologi
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- James, Stefan, 1964- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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(creator_code:org_t)
- Elsevier, 2022
- 2022
- English.
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In: JACC. - : Elsevier. - 1936-8798 .- 1876-7605. ; 15:20, s. 2066-2076
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https://uu.diva-port... (primary) (Raw object)
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Abstract
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- BACKGROUND: Women have a worse prognosis after ST-segment elevation myocardial infarction (STEMI) than men. The prognostic role of thrombus burden (TB) in influencing the sex-related differences in clinical outcomes after STEMI has not been clearly investigated.OBJECTIVES: The aim of this study was to assess the sex-related differences in TB and its clinical implications in patients with STEMI.METHODS: Individual patient data from the 3 major randomized clinical trials of manual thrombus aspiration were analyzed, encompassing a total of 19,047 patients with STEMI, of whom 13,885 (76.1%) were men and 4,371 (23.9%) were women. The primary outcome of interest was 1-year cardiovascular (CV) death. The secondary outcomes of interest were recurrent myocardial infarction, heart failure, all-cause mortality, stroke, stent thrombosis (ST), and target vessel revascularization at 1 year.RESULTS: Patients with high TB (HTB) had worse 1-year outcomes compared with those presenting with low TB (adjusted HR for CV death: 1.52; 95% CI: 1.10-2.12; P = 0.01). In unadjusted analyses, female sex was associated with an increased risk for 1-year CV death regardless of TB. After adjustment, the risk for 1-year CV death was higher only in women with HTB (HR: 1.23; 95% CI: 1.18-1.28; P < 0.001), who also had an increased risk for all-cause death and ST than men.CONCLUSIONS: In patients with STEMI, angiographic evidence of HTB negatively affected prognosis. Among patients with HTB, women had an excess risk for ST, CV, and all-cause mortality than men. Further investigations are warranted to better understand the pathophysiological mechanisms leading to excess mortality in women with STEMI and HTB.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- ST-segment elevation myocardial infarction
- TAPAS
- TASTE
- TIMI thrombus burden
- TOTAL
- women
Publication and Content Type
- ref (subject category)
- art (subject category)
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JACC
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Manzi, Maria Vir ...
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Buccheri, Sergio
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Jolly, Sanjit S.
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Zijlstra, Felix
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Fröbert, Ole, 19 ...
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Lagerqvist, Bo, ...
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Mahmoud, Karim D ...
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Džavík, Vladimír
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Barbato, Emanuel ...
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Sarno, Giovanna
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James, Stefan, 1 ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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JACC
- By the university
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Örebro University
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Uppsala University