The impact of sex and physical performance on long-term mortality in older patients with myocardial infarction.
BMC Med
; 20(1): 15, 2022 01 20.
Article
in En
| MEDLINE
| ID: mdl-35045843
ABSTRACT
BACKGROUND:
Sex influences outcome of patients with acute coronary syndrome (ACS). If there is a relationship between sex and physical performance is unknown.METHODS:
The analysis is based on older (≥70 years) ACS patients included in the FRASER, HULK, and LONGEVO SCA prospective studies. Physical performance was assessed by Short Physical Performance Battery (SPPB). The primary outcome was all-cause mortality.RESULTS:
The study included 1388 patients, and 441 (32%) were women. At presentation, women were older and more compromised than men. After a median follow-up of 998 [730-1168] days, all-cause death occurred in 334 (24.1%) patients. At univariate analysis, female sex was related to increased risk of death. After adjustments for confounding factors, female sex was no longer associated with mortality. Women showed poor physical performance compared with men (p < 0.001). SPPB values emerged as an independent predictor of death. Including clinical features and SPPB in the multivariable model, we observed a paradigm shift in the prognostic role of female sex that becomes a protective factor (HR 0.73, 95% CI 0.56-0.96). Sex and physical performance showed a significant interaction (p = 0.03). For lower SPPB values (poor physical performance), sex-related changes in mortality were not recorded, while in patients with higher SPPB values (preserved physical performance), female sex was associated with better survival.CONCLUSIONS:
Two key findings emerged from the present real-life cohort of older ACS patients (i) physical performance strongly influences long-term mortality; (ii) women with preserved physical performance have a better outcome compared to men. TRIAL REGISTRATION www.clinicaltrials.gov NCT02386124 and NCT03021044.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Acute Coronary Syndrome
/
Myocardial Infarction
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
BMC Med
Journal subject:
MEDICINA
Year:
2022
Type:
Article
Affiliation country:
Italy