Very long-term outcomes after acute myocardial infarction in young men and women: Insights from the FAST-MI program.
Arch Cardiovasc Dis
; 116(6-7): 324-334, 2023.
Article
in En
| MEDLINE
| ID: mdl-37391340
ABSTRACT
AIMS:
Conflicting data exists about long-term outcomes in young women and men experiencing acute myocardial infarction (AMI).METHODS:
The FAST-MI program consists of three nationwide French surveys carried out 5years apart from 2005 to 2015, including consecutive patients with AMI over a 1-month period with up to 10-year follow-up. The present analysis focused on adults≤50 yo according to their gender.RESULTS:
Women accounted for 17.5% (335) of the 1912 patients under 50 yo and had a similar age as men (43.9±5.1 vs. 43.9±5.5years, P=0.92). They received less percutaneous coronary interventions (PCI) than men (85.9% vs. 91.3%, P=0.005), even in ST-elevation myocardial infarction (83.6% vs. 93.5%, P<0.001). Recommended secondary prevention medications were less frequently prescribed at discharge in women (40.6% vs. 52.8%, P<0.001), a trend that persisted in 2015 (59.1% vs. 72.8% in 2015, P<0.001). Still, ten-year survival was similar in men (90.5%) and women (92.3%) (crude HR 0.86 [95% CI 0.55-1.35], P=0.52, adjusted HR 0.63 [95% CI 0.38-1.07], P=0.09); similar results were found for ten-year survival among hospital survivors (91.2% in men vs. 93.7% in women, adjusted HR 0.87 [95% CI 0.45-1.66], P=0.66). Of the 1684 patients alive at hospital discharge with morbidity follow-up≥6months available, death, AMI or stroke at 8years occurred in 12.9% men and 11.2% in women (adjusted HR 0.90 [95% CI 0.60-1.33], P=0.59).CONCLUSIONS:
Young women with AMI undergo less cardiac interventions and are less often prescribed secondary prevention treatment than men, even when significant coronary artery disease is present, but keep a similar long-term prognosis after AMI. Optimal management of these young patients, regardless of gender, is necessary to ensure best outcomes after this major cardiovascular event.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Percutaneous Coronary Intervention
/
Myocardial Infarction
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
En
Journal:
Arch Cardiovasc Dis
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Francia