Assessed risk factors for short term mortality in patients with STEMI

The risk of death within 30 days after admission with myocardial infarction with ST-segment elevation (STEMI) more than two times higher among women under 60 years compared with men in the same age category, according to Medscape, citing the results of a study published in the journal JAMA Internal Medicine.

Previous studies have shown that women hospitalized with STEMI have a higher short-term mortality than men. However, it remained unclear whether these differences in patients undergoing primary percutaneous coronary intervention (PCI).

The purpose of this study was to determine whether the risk of 30-day mortality after STEMI is higher in women than in men, and if so, to evaluate the role of age, medicines and primary PCI in excess of risk.

For this, the researchers analyzed data from 2657 women (mean age 66.1 years) and 6177 men (average age from 59.9 years) who underwent treatment of STEMI in 41 hospital in 12 countries.

The results showed that 30-day mortality was significantly higher among women than among men (11.6% vs 6,0%). Thus the gap was reduced when restricting the analysis to men and women held primary PCI (7,1% versus 3.3%). After multivariable adjustments, including taking into account comorbidities, women under 60 years had a higher risk of early mortality than men of the same age. Between the sexes in subgroups of patients from 60 to 74 years and over 75 years, the risk did not differ significantly.

Thus, younger age was associated with higher rates of mortality within 30 days among women with STEMI even after adjustment for medications, primary PCI and other comorbidities. This difference decreases after age 60 and is not observed in older women, the researchers concluded.