Sex-based differences in long-term outcomes after early-onset myocardial infarction

Maddalena Ardissino, Adam J. Nelson, Giuseppe Maglietta, Guidantonio Malagoli Tagliazucchi, Caterina Disisto, Umberto Canosi, Carlo Cernetti, Piera Angelica Merlini, Carlo Berzuini, Elisabetta Ponte, Raffaella Fetiveau, Silvia Buratti, Elvezia Paraboschi, Stefano Duga, Domenico Tuttolomondo, Antonio Crocamo, Federico Barocelli, Serena Bricoli, Andrea Botti, Rosario BonuraGiulia Magnani, Andrea Biagi, Giorgia Paoli, Emilia Solinas, Diego Ardissino

Research output: Contribution to journalArticlepeer-review


There is growing appreciation for sex-based differences in cardiovascular risk, but little is known about whether these extend to pre-menopausal females experiencing early-onset myocardial infarction (MI) who might benefit from the protective effects of estrogen exposure.

The Italian Genetic Study of Early-Onset Myocardial Infarction was a nationwide prospective cohort study involving 125 centres which, between 1998 and 2002, enrolled 2,000 consecutive patients who experienced a first MI before the age of 45 years and underwent coronary angiography at the time of the index event, and followed them up for a median of 19.9 years. The primary composite endpoint was cardiovascular death, non-fatal MI and non-fatal stroke.

Follow-up was completed by 1,984 patients (98.2%) with a median age of 41 years (IQR 37-43): 1,778 men (88.9%) men and 222 women (11.1%). Smoking (46.5% vs 42.8%), dyslipidemia (62.9% vs 50.7%) and diabetes (7.8% vs 5.4%) were more frequent among the men (all p
Significant sex-based differences in baseline risk factors and outcomes were observed in patients with early-onset MI: women presented with a lower atherosclerotic disease burden and, despite having lower rates of secondary prevention measures, experienced better long-term outcomes.
Original languageEnglish
Pages (from-to)206
Number of pages1
JournalJournal of the American College of Cardiology
Issue number11
Publication statusPublished - 24 Mar 2020


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