Korean Circ J.  2000 Oct;30(10):1245-1256. 10.4070/kcj.2000.30.10.1245.

Age-Related Difference in Long-Term Prognosis of Acute Myocardial Infarction in Women

• Chung B
• Ha JW
• Choi D
• Jang Y
• Ahn SK
• Rim SJ
• Chung N
• Shim WH
• Cho SY
• Kim SS

• KMID: 1938409
• DOI: http://doi.org/10.4070/kcj.2000.30.10.1245

Abstract

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the age-related differences in clinical features, coronary anatomy, risk factors, hospital courses, and long-term prognosis of acute myocardial infarction(AMI) in women.
MATERIALS AND METHODS
Total 513 female patients with AMI were divided into 3 groups ; group 1(n=3, 50 years old or less), group 2(n=02, between 51 years and 70 years old), and group 3(n=68, older than 70 years). Clinical follow-up including cardiac events was performed for mean duration of 26 months(1~155 months). Cardiac events include cardiac death, reinfarction, CABG, PTCA, CHF, stroke, and recurrent angina.
RESULTS
Minimal lesion(<50% stenosis) in infarct-related artery was more prevalent in group 1 than in group 3(p<0.05). In group 2, the number of low high density lipoprotein(HDL) was significantly more than in group 3(p<0.01). During hospitalization, death and shock were more prevalently observed in group 3 than group 1(p<0.005) and group 2(p<0.001). Group 3 had more heart failures than group 1(p<0.001) and group 2(p<0.001) and group 2 had more heart failures than group 1(p<0.05). The younger age group showed a significantly higher survial rate(7 years : group 1; 76.1%, group 2; 60.6%, group 3; 34.2%, p<0.0001, Log Rank Stat =49.4) and cardiac event-free survival rate(7 years : group 1; 48.4%, group 2; 32.3%, group 3; 16.0%, p<0.0001, Log Rank Stat =37.5) for each 3 comparisons. In Cox proportional harzard analysis, LV systolic function influenced the group 2 survival (odds ratio 3.8, 95% CI 1.7 to 8.3, p<0.005) and the group 3 survival (odds ratio 2.2, 95% CI 1.1 to 4.5, p<0.05). The cardiac event free survival was influenced by age(odds ratio 1.6, 95% CI 1.2 to 2.1, p<0.005) and LV systolic function(odds ratio 1.8, 95% CI 1.3 to 2.5, p<0.001).
CONCLUSION
Younger female patients with AMI had a more favorable prognosis compared with older female patients. LV systolic fuction was important as a prognostic factor for long-term survival except younger female AMI patients.

MeSH Terms

Arteries
Death
Disease-Free Survival
Female
Follow-Up Studies
Heart
Hospitalization
Humans
Middle Aged
Myocardial Infarction*
Prognosis*
Risk Factors
Shock
Stroke