Women with acute MI at lower risk of ventricular fibrillation compared to men: JAHA

FRANCE: Compared to men, women are at a decreased risk of developing ventricular fibrillation during an episode of acute myocardial infarction (AMI), states a study published in the Journal of the American Heart Association.

At any instant during an acute myocardial infarction, life-threatening ventricular arrhythmias like ventricular fibrillation (VF) can develop (AMI). Although less common in women, ventricular fibrillation complicating acute myocardial infarction is nonetheless not unusual. There is not much information available on women who present with acute myocardial infarction and ventricular fibrillation (VF). This study is the first to offer details on the prevalence of ventricular fibrillation in female patients who have experienced an acute myocardial infarction.

The researchers evaluated frequency, VF factors, and consequences, paying particular attention to women in comparison to men.

The study prospectively included 14 406 patients enrolled in French cardiac intensive care units within 48 hours following the occurrence of an AMI between 1995 and 2015 with a mean age of 66±14 years, out of which 72% were men, with a mean left ventricular ejection fraction, 52±12% and 59% with ST-segment-elevation MI. The French Registry of Acute ST-Elevation or Non-ST-Elevation Myocardial Infarction (FAST-MI) program's data were reviewed. 359 patients in total experienced VF during AMI, including 278 men and 81 women.

Key points of the study:

• There was an independent relationship between the commencement of VF during AMI and ST-segment-elevation myocardial infarction (odds ratio [OR], 2.29).
• Contrarily, prior myocardial infarction (OR, 0.69), female sex (OR, 0.73), and hypertension (OR, 0.75) were protective variables.
• Higher 1-year mortality in women than in men (50.6% versus 37.4%, respectively), including higher in-hospital mortality (42.0% versus 32.7%, respectively) was seen.
• Women were less likely than men to undergo cardiac intervention (percutaneous coronary intervention during hospitalization 48.1% versus 66.9%, respectively).
• Female sex was no longer linked to worse 1-year mortality after adjustment (adjusted hazard ratio: 1.10).

"The long-term prognosis for women who report with VF at the acute stage of MI may be further improved by bridging the gender gap in terms of timely care and appropriate secondary preventive medication therapy", they wrote.

The authors concluded that women had ventricular fibrillation following acute myocardial infarction less frequently than men, with the female sex acting as an independent protective determinant.

REFERENCE

Weizman O, Marijon E, Narayanan K, Boveda S, Defaye P, Martins R, Deharo JC, Laurent G, Klug D, Sadoul N, Hocini M, Mansencal N, Anselme F, Da Costa A, Maury P, Ferrières J, Schiele F, Simon T, Danchin N; FAST‐MI Program Investigators. Incidence, Characteristics, and Outcomes of Ventricular Fibrillation Complicating Acute Myocardial Infarction in Women Admitted Alive in the Hospital. J Am Heart Assoc. 2022 Aug 26:e025959. doi: 10.1161/JAHA.122.025959. Epub ahead of print. PMID: 36017613.