Effect of Gender on Patients With ST-Elevation and Non-ST-Elevation Myocardial Infarction Without Obstructive Coronary Artery Disease
The aim of this study was to compare the prognoses of patients with ST-segment elevation myocardial infarction (STEMI) and those with non-ST-segment elevation myocardial infarction (NSTEMI) without obstructive coronary artery disease (CAD) and the risk associated with gender for future cardiovascula...
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| Veröffentlicht in: | The American journal of cardiology 2015-06, Vol.115 (12), p.1661-1666 |
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| container_title | The American journal of cardiology |
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| creator | Johnston, Nina, MD, PhD Jönelid, Birgitta, MD Christersson, Christina, MD, PhD Kero, Tanja, MD Renlund, Henrik, PhD Schenck-Gustafsson, Karin, MD, PhD Lagerqvist, Bo, MD, PhD |
| description | The aim of this study was to compare the prognoses of patients with ST-segment elevation myocardial infarction (STEMI) and those with non-ST-segment elevation myocardial infarction (NSTEMI) without obstructive coronary artery disease (CAD) and the risk associated with gender for future cardiovascular events. The study population was selected from 95,849 patients who underwent coronary angiography for myocardial infarction from 2005 to 2010 and registered in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Outcome analyses, including all-cause death, myocardial infarction, congestive heart failure, stroke, and revascularization, were performed in 2,268 patients with STEMI and 10,904 with NSTEMI without obstructive CAD ( |
| doi_str_mv | 10.1016/j.amjcard.2015.03.006 |
| format | Article |
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The study population was selected from 95,849 patients who underwent coronary angiography for myocardial infarction from 2005 to 2010 and registered in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Outcome analyses, including all-cause death, myocardial infarction, congestive heart failure, stroke, and revascularization, were performed in 2,268 patients with STEMI and 10,904 with NSTEMI without obstructive CAD (<50% stenosis). Hazard ratios and 95% confidence intervals comparing women with men were calculated for events, adjusting for cardiovascular risk factors and age. Nonobstructive CAD was found in 7% of patients with STEMI (6% men, 10% women) and in 17% of those with NSTEMI (11% men, 28% women). During a median follow-up of 2.6 years, 8% of patients with STEMI and 5% of those with NSTEMI died. Gender-associated differences in risk were observed in patients with NSTEMI, with adjusted hazard ratios lower in women than men for mortality (hazard ratio 0.90, 95% confidence interval 0.50 to 0.73) and congestive heart failure (hazard ratio 0.61, 95% confidence interval 0.52 to 0.72). In the 2 groups, women underwent less revascularization. In conclusion, nonobstructive CAD was more common in patients with NSTEMI than those with STEMI, as well as in women compared with men. Long-term mortality in patients with nonobstructive CAD was higher after STEMI than NSTEMI. The gender differences in outcomes suggest gender differences in the underlying pathogenesis of myocardial infarction without obstructive CAD.</description><identifier>ISSN: 0002-9149</identifier><identifier>ISSN: 1879-1913</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2015.03.006</identifier><identifier>PMID: 25900352</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cardiology ; Cardiovascular ; Cause of Death ; Chest Pain - epidemiology ; Coronary Angiography ; Coronary Artery Disease - pathology ; Coronary vessels ; Electrocardiography ; Female ; Follow-Up Studies ; Heart attacks ; Humans ; Kaplan-Meier Estimate ; Male ; Mortality ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - mortality ; Myocardial Infarction - pathology ; Older people ; Prognosis ; Registries ; Risk Factors ; Sex Factors ; Stroke - epidemiology ; Sweden - epidemiology ; Womens health</subject><ispartof>The American journal of cardiology, 2015-06, Vol.115 (12), p.1661-1666</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jun 15, 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-bf4659365416966f89855a95b2649290e391d93e49426ec86244fd4a46184eb23</citedby><cites>FETCH-LOGICAL-c593t-bf4659365416966f89855a95b2649290e391d93e49426ec86244fd4a46184eb23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914915009613$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25900352$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-252759$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:131611993$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Johnston, Nina, MD, PhD</creatorcontrib><creatorcontrib>Jönelid, Birgitta, MD</creatorcontrib><creatorcontrib>Christersson, Christina, MD, PhD</creatorcontrib><creatorcontrib>Kero, Tanja, MD</creatorcontrib><creatorcontrib>Renlund, Henrik, PhD</creatorcontrib><creatorcontrib>Schenck-Gustafsson, Karin, MD, PhD</creatorcontrib><creatorcontrib>Lagerqvist, Bo, MD, PhD</creatorcontrib><title>Effect of Gender on Patients With ST-Elevation and Non-ST-Elevation Myocardial Infarction Without Obstructive Coronary Artery Disease</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>The aim of this study was to compare the prognoses of patients with ST-segment elevation myocardial infarction (STEMI) and those with non-ST-segment elevation myocardial infarction (NSTEMI) without obstructive coronary artery disease (CAD) and the risk associated with gender for future cardiovascular events. The study population was selected from 95,849 patients who underwent coronary angiography for myocardial infarction from 2005 to 2010 and registered in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Outcome analyses, including all-cause death, myocardial infarction, congestive heart failure, stroke, and revascularization, were performed in 2,268 patients with STEMI and 10,904 with NSTEMI without obstructive CAD (<50% stenosis). Hazard ratios and 95% confidence intervals comparing women with men were calculated for events, adjusting for cardiovascular risk factors and age. Nonobstructive CAD was found in 7% of patients with STEMI (6% men, 10% women) and in 17% of those with NSTEMI (11% men, 28% women). During a median follow-up of 2.6 years, 8% of patients with STEMI and 5% of those with NSTEMI died. Gender-associated differences in risk were observed in patients with NSTEMI, with adjusted hazard ratios lower in women than men for mortality (hazard ratio 0.90, 95% confidence interval 0.50 to 0.73) and congestive heart failure (hazard ratio 0.61, 95% confidence interval 0.52 to 0.72). In the 2 groups, women underwent less revascularization. In conclusion, nonobstructive CAD was more common in patients with NSTEMI than those with STEMI, as well as in women compared with men. Long-term mortality in patients with nonobstructive CAD was higher after STEMI than NSTEMI. The gender differences in outcomes suggest gender differences in the underlying pathogenesis of myocardial infarction without obstructive CAD.</description><subject>Cardiology</subject><subject>Cardiovascular</subject><subject>Cause of Death</subject><subject>Chest Pain - epidemiology</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Disease - pathology</subject><subject>Coronary vessels</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Mortality</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - pathology</subject><subject>Older people</subject><subject>Prognosis</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Stroke - epidemiology</subject><subject>Sweden - epidemiology</subject><subject>Womens health</subject><issn>0002-9149</issn><issn>1879-1913</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFks9uEzEQxi0EoiHwCCBLXDiwwf-7vlBFaSiVCkVqgaPl9c6C08062LtBeQDeGy8JRVRCnGx__s14xvMh9JSSGSVUvVrN7HrlbKxnjFA5I3xGiLqHJrQ81gXVlN9HE0IIKzQV-gg9SmmVj5RK9RAdMakJ4ZJN0I9l04DrcWjwGXQ1RBw6_MH2Hro-4c--_4qvrotlC9us5Svb1fh96Iq_xHe7MFbibYvPu8ZG90sdg8PQ48sq9XHI2hbwIsTQ2bjD89hDXk59ApvgMXrQ2DbBk8M6RR_fLK8Xb4uLy7PzxfyicFLzvqgaofJGSUGVVqopdSml1bJiSmimCXBNa81BaMEUuFIxIZpaWKFoKaBifIqKfd70HTZDZTbRr3M1JlhvDtJN3oGRVBBBM__yn_yp_zQ3IX4xw2CYZMe5sCl6scc3MXwbIPVm7ZODtrUdhCEZqkohuMjzyujzO-gqDLHLzY8Up0QzMiaUe8rFkFKE5rYCSsxoA7MyBxuY0QaGcJNtkOOeHbIP1Rrq26jfc8_AyR6A_NtbD9Ekl0fuoPYx28HUwf_3idd3MrjWd97Z9gZ2kP50YxIzxFyNXhytSCUhWlHOfwLxPtof</recordid><startdate>20150615</startdate><enddate>20150615</enddate><creator>Johnston, Nina, MD, PhD</creator><creator>Jönelid, Birgitta, MD</creator><creator>Christersson, Christina, MD, PhD</creator><creator>Kero, Tanja, MD</creator><creator>Renlund, Henrik, PhD</creator><creator>Schenck-Gustafsson, Karin, MD, PhD</creator><creator>Lagerqvist, Bo, MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DF2</scope></search><sort><creationdate>20150615</creationdate><title>Effect of Gender on Patients With ST-Elevation and Non-ST-Elevation Myocardial Infarction Without Obstructive Coronary Artery Disease</title><author>Johnston, Nina, MD, PhD ; Jönelid, Birgitta, MD ; Christersson, Christina, MD, PhD ; Kero, Tanja, MD ; Renlund, Henrik, PhD ; Schenck-Gustafsson, Karin, MD, PhD ; Lagerqvist, Bo, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c593t-bf4659365416966f89855a95b2649290e391d93e49426ec86244fd4a46184eb23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Cardiology</topic><topic>Cardiovascular</topic><topic>Cause of Death</topic><topic>Chest Pain - epidemiology</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Disease - pathology</topic><topic>Coronary vessels</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Mortality</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - pathology</topic><topic>Older people</topic><topic>Prognosis</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Stroke - epidemiology</topic><topic>Sweden - epidemiology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johnston, Nina, MD, PhD</creatorcontrib><creatorcontrib>Jönelid, Birgitta, MD</creatorcontrib><creatorcontrib>Christersson, Christina, MD, PhD</creatorcontrib><creatorcontrib>Kero, Tanja, MD</creatorcontrib><creatorcontrib>Renlund, Henrik, PhD</creatorcontrib><creatorcontrib>Schenck-Gustafsson, Karin, MD, PhD</creatorcontrib><creatorcontrib>Lagerqvist, Bo, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Uppsala universitet</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johnston, Nina, MD, PhD</au><au>Jönelid, Birgitta, MD</au><au>Christersson, Christina, MD, PhD</au><au>Kero, Tanja, MD</au><au>Renlund, Henrik, PhD</au><au>Schenck-Gustafsson, Karin, MD, PhD</au><au>Lagerqvist, Bo, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Gender on Patients With ST-Elevation and Non-ST-Elevation Myocardial Infarction Without Obstructive Coronary Artery Disease</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2015-06-15</date><risdate>2015</risdate><volume>115</volume><issue>12</issue><spage>1661</spage><epage>1666</epage><pages>1661-1666</pages><issn>0002-9149</issn><issn>1879-1913</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>The aim of this study was to compare the prognoses of patients with ST-segment elevation myocardial infarction (STEMI) and those with non-ST-segment elevation myocardial infarction (NSTEMI) without obstructive coronary artery disease (CAD) and the risk associated with gender for future cardiovascular events. The study population was selected from 95,849 patients who underwent coronary angiography for myocardial infarction from 2005 to 2010 and registered in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Outcome analyses, including all-cause death, myocardial infarction, congestive heart failure, stroke, and revascularization, were performed in 2,268 patients with STEMI and 10,904 with NSTEMI without obstructive CAD (<50% stenosis). Hazard ratios and 95% confidence intervals comparing women with men were calculated for events, adjusting for cardiovascular risk factors and age. Nonobstructive CAD was found in 7% of patients with STEMI (6% men, 10% women) and in 17% of those with NSTEMI (11% men, 28% women). During a median follow-up of 2.6 years, 8% of patients with STEMI and 5% of those with NSTEMI died. Gender-associated differences in risk were observed in patients with NSTEMI, with adjusted hazard ratios lower in women than men for mortality (hazard ratio 0.90, 95% confidence interval 0.50 to 0.73) and congestive heart failure (hazard ratio 0.61, 95% confidence interval 0.52 to 0.72). In the 2 groups, women underwent less revascularization. In conclusion, nonobstructive CAD was more common in patients with NSTEMI than those with STEMI, as well as in women compared with men. Long-term mortality in patients with nonobstructive CAD was higher after STEMI than NSTEMI. The gender differences in outcomes suggest gender differences in the underlying pathogenesis of myocardial infarction without obstructive CAD.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25900352</pmid><doi>10.1016/j.amjcard.2015.03.006</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Cardiology Cardiovascular Cause of Death Chest Pain - epidemiology Coronary Angiography Coronary Artery Disease - pathology Coronary vessels Electrocardiography Female Follow-Up Studies Heart attacks Humans Kaplan-Meier Estimate Male Mortality Myocardial Infarction - diagnostic imaging Myocardial Infarction - mortality Myocardial Infarction - pathology Older people Prognosis Registries Risk Factors Sex Factors Stroke - epidemiology Sweden - epidemiology Womens health |
| title | Effect of Gender on Patients With ST-Elevation and Non-ST-Elevation Myocardial Infarction Without Obstructive Coronary Artery Disease |
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