ST-Elevation Myocardial Infarction as a First Event.

Fischer, Alicia Jeanette; Feld, Jannik; Makowski, Lena; Engelbertz, Christiane; Kühnemund, Leonie; Günster, Christian; Dröge, Patrik; Ruhnke, Thomas; Gerß, Joachim; Freisinger, Eva; Reinecke, Holger; Köppe, Jeanette

Forschungsartikel (Zeitschrift) | Peer reviewed

Zusammenfassung

Background: Survival after ST-elevation myocardial infarction (STEMI) as a first event in Germany was analyzed. Methods: Adults with a first-event STEMI were included for analysis on the basis of insurance data from a German health insurance provider (AOK; approximately 26 million members; median follow-up 48.5 months). The primary endpoints were 30-day mortality, reinfarction or death, major adverse cardiovascular and cerebro - vascular events (MACCE), long-term survival for more than 90 days, and overall survival (OS). Results: STEMI occurred in 17 444 patients (32.8% women). The women were older than the men (median age 74 versus 60 years) and suffered more frequently from cardiovascular comorbidities such as diabetes mellitus, chronic renal disease, and arterial hypertension. Women underwent endovascular or surgical treatment less frequently, but sustained complications (cardiogenic shock, resuscitation) more frequently. After adjustment of the data, women were at higher risk of 30-day mortality (odds ratio [OR] 1.17, 95% confidence interval [95% CI] [1.07; 1.28]), reinfarction or death (hazard ratio [HR] 1.09, 95% CI [1.04; 1.16]), MACCE (HR 1.09, 95% CI [1.04; 1.15]), and poorer OS (HR 1.10, 95% CI [1.04; 1.17]). This effect was especially pronounced in women aged ≤ 60 years. No differences between the sexes were seen among patients who survived for 90 days after the infarction. Conclusion: In Germany, women ≤ 60 years display a higher 30-day mortality after first-event STEMI, which affects their overall survival. Younger women should receive intensified medical attention after STEMI, especially in the early phase.

Details zur Publikation

FachzeitschriftDeutsches Ärzteblatt international (Dtsch Arztebl Int)
Jahrgang / Bandnr. / Volume119
Ausgabe / Heftnr. / Issue16
Seitenbereich284-292
StatusVeröffentlicht
Veröffentlichungsjahr2022 (22.05.2022)
Sprache, in der die Publikation verfasst istEnglisch
DOI10.3238/arztebl.m2022.0161
Stichwörteracute myocardial infarction; ST-segment elevation myocardial infarction; gender; sex differences; gender differences; determinants; mortality

Autor*innen der Universität Münster

Engelbertz, Christiane Maria
Klinik für Kardiologie I
Feld, Jannik
Institut für Biometrie und Klinische Forschung (IBKF)
Freisinger, Eva
Klinik für Kardiologie I
Friedrich, Alicia Jeanette
Klinik für Kardiologie III
Gerß, Joachim
Institut für Biometrie und Klinische Forschung (IBKF)
Köppe, Jeanette
Institut für Biometrie und Klinische Forschung (IBKF)
Makowski, Lena-Maria
Klinik für Kardiologie I
Padberg, Leonie
Klinik für Kardiologie I
Reinecke, Holger
Klinik für Kardiologie I