Abstract / Description of output
Objectives: Type 2 myocardial infarction (MI) is a heterogenous condition and whether there are differences between women and men is unknown. We evaluated sex differences in clinical characteristics, investigations and outcomes in patients with type 2 MI.
Methods: In the SWEDEHEART registry, we compared patients admitted to coronary care units with a diagnosis of type 1 or type 2 MI. Sex-stratified Cox regression models evaluated the association with all-cause death in men and women separately.
Results: We included 57,264 (median age 73 years, 65% men) and 6,485 (median age 78 years, 50% men) patients with type 1 and type 2 MI, respectively. No differences were observed in the proportion of men and women with type 2 MI who underwent echocardiography and coronary angiography, but women were less likely than men to have left ventricular (LV) impairment and obstructive coronary artery disease (CAD). Compared to type 1 MI, type 2 MI patients had higher risk of death regardless of sex (men, adjusted HR: 1.55 [95% CI,1.44-1.67]; women, adjusted HR: 1.34 [95% CI,1.24-1.45]). In those with type 2 MI the risk of death was lower for women than men (adjusted HR 0.85, 95% CI,0.76-0.92 [men, reference]).
Conclusions: Type 2 MI occurred in men and women equally and we found no evidence of sex-bias in the selection of patients for cardiac investigations. Type 2 MI patients had worse outcomes, but women were less likely to have obstructive CAD or severe LV impairment and were more likely to survive than men.
Methods: In the SWEDEHEART registry, we compared patients admitted to coronary care units with a diagnosis of type 1 or type 2 MI. Sex-stratified Cox regression models evaluated the association with all-cause death in men and women separately.
Results: We included 57,264 (median age 73 years, 65% men) and 6,485 (median age 78 years, 50% men) patients with type 1 and type 2 MI, respectively. No differences were observed in the proportion of men and women with type 2 MI who underwent echocardiography and coronary angiography, but women were less likely than men to have left ventricular (LV) impairment and obstructive coronary artery disease (CAD). Compared to type 1 MI, type 2 MI patients had higher risk of death regardless of sex (men, adjusted HR: 1.55 [95% CI,1.44-1.67]; women, adjusted HR: 1.34 [95% CI,1.24-1.45]). In those with type 2 MI the risk of death was lower for women than men (adjusted HR 0.85, 95% CI,0.76-0.92 [men, reference]).
Conclusions: Type 2 MI occurred in men and women equally and we found no evidence of sex-bias in the selection of patients for cardiac investigations. Type 2 MI patients had worse outcomes, but women were less likely to have obstructive CAD or severe LV impairment and were more likely to survive than men.
| Original language | English |
|---|---|
| Journal | Heart |
| Early online date | 21 Apr 2021 |
| DOIs | |
| Publication status | E-pub ahead of print - 21 Apr 2021 |