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Sex-Related Differences in Thrombus Burden in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention
- Source :
- Manzi, M V, Buccheri, S, Jolly, S S, Zijlstra, F, Frøbert, O, Lagerqvist, B, Mahmoud, K D, Džavík, V, Barbato, E, Sarno, G & James, S 2022, ' Sex-Related Differences in Thrombus Burden in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention ', JACC: Cardiovascular Interventions, vol. 15, no. 20, pp. 2066-2076 . https://doi.org/10.1016/j.jcin.2022.08.013, JACC: Cardiovascular Interventions, 15(20), 2066-2076. Elsevier Inc.
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Background: Women have a worse prognosis after ST-segment elevation myocardial infarction (STEMI) than men. The prognostic role of thrombus burden (TB) in influencing the sex-related differences in clinical outcomes after STEMI has not been clearly investigated. Objectives: The aim of this study was to assess the sex-related differences in TB and its clinical implications in patients with STEMI. Methods: Individual patient data from the 3 major randomized clinical trials of manual thrombus aspiration were analyzed, encompassing a total of 19,047 patients with STEMI, of whom 13,885 (76.1%) were men and 4,371 (23.9%) were women. The primary outcome of interest was 1-year cardiovascular (CV) death. The secondary outcomes of interest were recurrent myocardial infarction, heart failure, all-cause mortality, stroke, stent thrombosis (ST), and target vessel revascularization at 1 year. Results: Patients with high TB (HTB) had worse 1-year outcomes compared with those presenting with low TB (adjusted HR for CV death: 1.52; 95% CI: 1.10-2.12; P = 0.01). In unadjusted analyses, female sex was associated with an increased risk for 1-year CV death regardless of TB. After adjustment, the risk for 1-year CV death was higher only in women with HTB (HR: 1.23; 95% CI: 1.18-1.28; P < 0.001), who also had an increased risk for all-cause death and ST than men. Conclusions: In patients with STEMI, angiographic evidence of HTB negatively affected prognosis. Among patients with HTB, women had an excess risk for ST, CV, and all-cause mortality than men. Further investigations are warranted to better understand the pathophysiological mechanisms leading to excess mortality in women with STEMI and HTB.
- Subjects :
- Male
TAPAS
Kardiologi
TASTE
Coronary Thrombosis
TOTAL
ST-segment elevation myocardial infarction
Percutaneous Coronary Intervention
Treatment Outcome
TIMI thrombus burden
Humans
ST Elevation Myocardial Infarction
Female
Cardiac and Cardiovascular Systems
women
Neoplasm Recurrence, Local
Cardiology and Cardiovascular Medicine
Thrombectomy
Subjects
Details
- ISSN :
- 19368798
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- JACC: Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....ffbaf354493db63364d58bd4080397a5