Abstract
Background
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.
Methods
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.
Results
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
Conclusion
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.
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.
Methods
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.
Results
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
Conclusion
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 language | English |
|---|---|
| Pages (from-to) | 206 |
| Number of pages | 1 |
| Journal | Journal of the American College of Cardiology |
| Volume | 75 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 24 Mar 2020 |