Similar long-term prognosis in women after acute MI as in men despite less secondary prevention

women after acute MI as in men despite less secondary preventionFrance: A recent study published in the Archives of Cardiovascular Diseases has presented conflicting data regarding the long-term outcomes of young men and women with acute myocardial infarction (AMI).

The study by Orianne Weizman and a team of researchers conducted in France analyzed the differences in treatment and long-term prognosis between genders in patients aged 50 years or younger. They revealed that young women with AMI undergo fewer cardiac interventions and are less often prescribed secondary prevention treatment than men, even with significant coronary artery disease (CAD). However, they keep a similar long-term prognosis after AMI.

"Therefore, the optimal management of these young patients is necessary, regardless of gender, to ensure the best outcomes after this major cardiovascular event," they wrote.

The study utilized data from the FAST-MI program, which involved three national surveys conducted over ten years, from 2005 to 2015. The analysis focused on adults aged 50 or younger, comparing men and women regarding treatment received and long-term outcomes. A total of 1,912 patients were included, with women accounting for 17.5% of the cohort.

● Women in the study had a similar age to men but received fewer percutaneous coronary interventions (PCI) than their male counterparts.

● Even in cases of ST-elevation myocardial infarction, women were less likely to undergo PCI.

● Additionally, recommended secondary prevention medications were less frequently prescribed to women at discharge, and this trend persisted over the study period.

● Despite these disparities in treatment, the 10-year survival rate was similar between men (90.5%) and women (92.3%).

● The adjusted hazard ratio for long-term survival did not show a statistically significant difference between the genders.

● The analysis also examined outcomes among hospital survivors who had morbidity follow-up data available.

● The incidence of death, recurrent AMI, or stroke at 8 years was comparable between men (12.9%) and women (11.2%).

● The adjusted hazard ratio for these combined outcomes did not indicate a significant difference between genders.

The study revealed that young women with AMI receive fewer cardiac interventions and are less likely to be prescribed secondary prevention medications than men, even when significant coronary artery disease is present. Despite these disparities in treatment, young women exhibited a similar long-term prognosis to men after experiencing an AMI. The findings emphasize the importance of optimal management for young patients with AMI, irrespective of gender, to ensure the best possible outcomes following this major cardiovascular event.

Further research is warranted to explore the underlying factors contributing to these disparities in treatment and to develop strategies that promote equitable care for young women and men with AMI. Healthcare providers should remain vigilant in providing comprehensive and evidence-based management to all young patients presenting with AMI, considering their long-term prognosis and individualized treatment needs.

Reference:

Weizman, O., Tea, V., Marijon, E., Eltchaninoff, H., Manzo-Silberman, S., Leclercq, F., Albert, F., Bataille, V., Drouet, E., Naccache, N., Puymirat, E., Ferrières, J., Schiele, F., Simon, T., Danchin, N., & FAST-MI investigators. (2023). Very long-term outcomes after acute myocardial infarction in young men and women: Insights from the FAST-MI program. Archives of Cardiovascular Diseases.https://doi.org/10.1016/j.acvd.2023.05.006