Korean J Med.  2019 Feb;94(1):96-106. 10.3904/kjm.2019.94.1.96.

Impact of Gender Differences in Elderly Patients with Acute Myocardial Infarction

• Seol SY
• Jeong MH
• Lee SH
• Sohn SJ
• Cho JY
• Kim MC
• Sim DS
• Hong YJ
• Park HW
• Kim JH
• Ahn Y
• Cho JG
• Park JC

• KMID: 2438031
• DOI: http://doi.org/10.3904/kjm.2019.94.1.96

Abstract

BACKGROUND/AIMS
It is well known that gender differences are associated with clinical outcomes in patients with acute myocardial infarction (AMI). However, it is not clear whether gender differences affect the prognosis of elderly patients with AMI.
METHODS
We analyzed the incidence of in-hospital complications and mortality in the Korea Acute Myocardial Infarction Registry-National Institutes of Health from November 2011 to June 2015. This study included elderly patients (≥ 75 years) diagnosed with AMI.
RESULTS
A total of 2,953 patients were eligible for this study. Among them, 1,529 (51.8%) patients were female, and the mean age of the female group was older than that of the male group (80.7 ± 4.4 vs. 79.6 ± 4.0 years, respectively, p < 0.001). Elderly females utilized emergency medical services less frequently compared with elderly males (11.5 vs. 15.4%, respectively, p < 0.001). Elderly female AMI patients had a similar rate of in-hospital mortality compared with elderly males (7.1 vs. 8.4%, respectively, p = 0.196). The rate of major cardiac adverse events (MACEs) was lower in elderly females than males during a 12-month follow-up (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.00-1.41, p = 0.045). According to multivariate analysis, the male gender is an independent factor for predicting 1-year MACEs (HR 1.37, 95% CI 1.14-1.65, p < 0.001).
CONCLUSIONS
No significant differences in peri-procedural complications or in-hospital mortality were observed between male and female elderly patients with AMI. However, elderly female patients had a more favorable prognosis than male patients during a 1-year clinical follow-up.

Keyword

Myocardial infarction; Prognosis; Gender

MeSH Terms

Academies and Institutes
Aged*
Emergency Medical Services
Female
Follow-Up Studies
Hospital Mortality
Humans
Incidence
Korea
Male
Mortality
Multivariate Analysis
Myocardial Infarction*
Prognosis