Open AccessLeft ventricular remodelling after ST‐segment elevation myocardial infarction: sex differences and prognosis
Author(s) -
Bijl Pieter,
Abou Rachid,
Goedemans Laurien,
Gersh Bernard J.,
Holmes David R.,
Ajmone Marsan Nina,
Delgado Victoria,
Bax Jeroen J.
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12618
Subject(s) - medicine , cardiology , conventional pci , myocardial infarction , percutaneous coronary intervention , ventricular remodeling , interquartile range , heart failure , ejection fraction , pharmacotherapy , population , environmental health
Aims Left ventricular (LV) remodelling after ST‐segment elevation myocardial infarction (STEMI) worsens outcome. The effect of sex on LV post‐infarct remodelling is unknown. We therefore investigated the sex distribution and long‐term prognosis of LV post‐infarct remodelling after STEMI in the contemporary era of primary percutaneous coronary intervention (PCI) and optimal pharmacotherapy. Methods and results Data were obtained from an ongoing primary PCI STEMI registry. LV remodelling was defined as ≥20% increase in LV end‐diastolic volume at either 3, 6, or 12 months post‐infarct, and LV remodelling impact on outcome was evaluated with a log‐rank test. A total population of 1995 STEMI patients were analysed (mean age 60 ± 12 years): 1527 (77%) men and 468 (23%) women. The mean age of male patients was 60±11 versus 63±13 years for women ( P < 0.001). A total of 953 (48%) patients experienced LV remodelling in the first 12 months of follow‐up, and it was equally frequent amongst men ( n = 729, 48%) and women ( n = 224, 48%). After a median follow‐up of 94 (interquartile range 69–119) months, 225 patients died: 171 (11%) men and 54 (12%) women. No survival difference was seen between remodellers and non‐remodellers in the male ( P = 0.113) and female ( P = 0.920) groups. Conclusion LV post‐infarct remodelling incidence, as well as long‐term survival of LV remodellers and non‐remodellers, was similar in men and women who were treated with primary PCI and optimal pharmacotherapy post‐STEMI.