Sex differences in the non-invasive risk stratification and prognosis after myocardial infarction

Daniel Sinnecker; Katharina M. Huster; Alexander Müller; Michael Dommasch; Alexander Hapfelmeier; Josef Gebhardt; Katerina Hnatkova; Karl Ludwig Laugwitz; Marek Malik; Petra Barthel; Georg Schmidt

doi:10.1016/j.jelectrocard.2014.08.010

Sex differences in the non-invasive risk stratification and prognosis after myocardial infarction

Daniel Sinnecker, Katharina M. Huster, Alexander Müller, Michael Dommasch, Alexander Hapfelmeier, Josef Gebhardt, Katerina Hnatkova, Karl Ludwig Laugwitz, Marek Malik, Petra Barthel, Georg Schmidt

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Background Women have unfavorable prognosis after myocardial infarction (MI). This text describes sex differences in mortality and in the power of risk predictors in contemporarily-treated MI patients.

Methods A population of 4141 MI patients (26.5% females) was followed up for 5 years. Effects of sex and age on total mortality were investigated by multivariable Cox analysis. Mortality predictors were investigated by receiver-operator characteristics analysis. Stepwise multivariable Cox regression was used to create sex-specific predictive models.

Results Thirty-day mortality was 1.5-fold higher in women. However, sex was not a significant mortality predictor in a model adjusted for age. Predictors for 5-year mortality performed differently in male and female patients. In women, a sex-specific model provided better risk stratification than a sex-neutral model.

Conclusion The unfavorable prognosis of female MI patients can be explained by advanced age. Sex-specific predictive models might improve risk stratification in female survivors of acute MI.

Original language	English
Pages (from-to)	874-880
Number of pages	7
Journal	Journal of Electrocardiology
Volume	47
Issue number	6
DOIs	https://doi.org/10.1016/j.jelectrocard.2014.08.010
State	Published - 1 Nov 2014

Keywords

ECG
Gender
Myocardial infarction
Risk stratification

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10.1016/j.jelectrocard.2014.08.010

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@article{db63a8949db04f7c9453140c48743de6,

title = "Sex differences in the non-invasive risk stratification and prognosis after myocardial infarction",

abstract = "Background Women have unfavorable prognosis after myocardial infarction (MI). This text describes sex differences in mortality and in the power of risk predictors in contemporarily-treated MI patients.Methods A population of 4141 MI patients (26.5\% females) was followed up for 5 years. Effects of sex and age on total mortality were investigated by multivariable Cox analysis. Mortality predictors were investigated by receiver-operator characteristics analysis. Stepwise multivariable Cox regression was used to create sex-specific predictive models.Results Thirty-day mortality was 1.5-fold higher in women. However, sex was not a significant mortality predictor in a model adjusted for age. Predictors for 5-year mortality performed differently in male and female patients. In women, a sex-specific model provided better risk stratification than a sex-neutral model.Conclusion The unfavorable prognosis of female MI patients can be explained by advanced age. Sex-specific predictive models might improve risk stratification in female survivors of acute MI.",

keywords = "ECG, Gender, Myocardial infarction, Risk stratification",

author = "Daniel Sinnecker and Huster, \{Katharina M.\} and Alexander M{\"u}ller and Michael Dommasch and Alexander Hapfelmeier and Josef Gebhardt and Katerina Hnatkova and Laugwitz, \{Karl Ludwig\} and Marek Malik and Petra Barthel and Georg Schmidt",

note = "Publisher Copyright: {\textcopyright} 2014 The Authors.",

year = "2014",

month = nov,

day = "1",

doi = "10.1016/j.jelectrocard.2014.08.010",

language = "English",

volume = "47",

pages = "874--880",

journal = "Journal of Electrocardiology",

issn = "0022-0736",

publisher = "Elsevier B.V.",

number = "6",

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TY - JOUR

T1 - Sex differences in the non-invasive risk stratification and prognosis after myocardial infarction

AU - Sinnecker, Daniel

AU - Huster, Katharina M.

AU - Müller, Alexander

AU - Dommasch, Michael

AU - Hapfelmeier, Alexander

AU - Gebhardt, Josef

AU - Hnatkova, Katerina

AU - Laugwitz, Karl Ludwig

AU - Malik, Marek

AU - Barthel, Petra

AU - Schmidt, Georg

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Background Women have unfavorable prognosis after myocardial infarction (MI). This text describes sex differences in mortality and in the power of risk predictors in contemporarily-treated MI patients.Methods A population of 4141 MI patients (26.5% females) was followed up for 5 years. Effects of sex and age on total mortality were investigated by multivariable Cox analysis. Mortality predictors were investigated by receiver-operator characteristics analysis. Stepwise multivariable Cox regression was used to create sex-specific predictive models.Results Thirty-day mortality was 1.5-fold higher in women. However, sex was not a significant mortality predictor in a model adjusted for age. Predictors for 5-year mortality performed differently in male and female patients. In women, a sex-specific model provided better risk stratification than a sex-neutral model.Conclusion The unfavorable prognosis of female MI patients can be explained by advanced age. Sex-specific predictive models might improve risk stratification in female survivors of acute MI.

AB - Background Women have unfavorable prognosis after myocardial infarction (MI). This text describes sex differences in mortality and in the power of risk predictors in contemporarily-treated MI patients.Methods A population of 4141 MI patients (26.5% females) was followed up for 5 years. Effects of sex and age on total mortality were investigated by multivariable Cox analysis. Mortality predictors were investigated by receiver-operator characteristics analysis. Stepwise multivariable Cox regression was used to create sex-specific predictive models.Results Thirty-day mortality was 1.5-fold higher in women. However, sex was not a significant mortality predictor in a model adjusted for age. Predictors for 5-year mortality performed differently in male and female patients. In women, a sex-specific model provided better risk stratification than a sex-neutral model.Conclusion The unfavorable prognosis of female MI patients can be explained by advanced age. Sex-specific predictive models might improve risk stratification in female survivors of acute MI.

KW - ECG

KW - Gender

KW - Myocardial infarction

KW - Risk stratification

UR - https://www.scopus.com/pages/publications/84908265747

U2 - 10.1016/j.jelectrocard.2014.08.010

DO - 10.1016/j.jelectrocard.2014.08.010

M3 - Article

C2 - 25175176

AN - SCOPUS:84908265747

SN - 0022-0736

VL - 47

SP - 874

EP - 880

JO - Journal of Electrocardiology

JF - Journal of Electrocardiology

IS - 6

ER -

Sex differences in the non-invasive risk stratification and prognosis after myocardial infarction

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Keywords

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