Gender differences in the development of heart failure after acute coronary syndrome: Insight from the CORALYS registry. in International journal of cardiology / Int J Cardiol. 2024 Feb 15;397:131622. doi: 10.1016/j.ijcard.2023.131622. Epub 2023 Dec 6.
2024
AOU Città della Salute di Torino
AOU San Luigi di Orbassano
Tipo pubblicazione
Observational Study
Autori/Collaboratori (40)Vedi tutti...
D'Ascenzo F
Division of Cardiology, "Città della Salute e della Scienza di Torino" Hospital, Department of Medical Sciences, University of Turin, Turin 10126, Italy.
Porto I
DICATOV-Cardiothoracic and Vascular Department, San Martino Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.
de Ferrari GM
Division of Cardiology, "Città della Salute e della Scienza di Torino" Hospital, Department of Medical Sciences, University of Turin, Turin 10126, Italy.
et alii...
Abstract
BACKGROUND: Impact of gender on heart remodeling after acute coronary syndrome (ACS) and consequently on development of heart failure (HF) remains to be elucidated. METHODS: CORALYS is a multicenter, retrospective, observational registry enrolling consecutive patients admitted for ACS and treated with percutaneous coronary intervention. HF hospitalization was the primary endpoint while all-cause mortality and the composite endpoint of incidence of first HF hospitalization and cardiovascular mortality were the secondary ones. RESULTS: Among 14,699 patients enrolled in CORALYS registry, 4578 (31%) were women and 10,121 (69%) males. Women were older, had more frequently hypertension and diabetes and less frequently smoking habit. History of myocardial infarction (MI), STEMI at admission and multivessel disease were less common in women. After median follow up of 2.9 ± 1.8 years, women had higher incidence of primary and secondary endpoints and female sex was an independent predictor of HF hospitalization (HR 1.26;1.05-1.50; p = 0.011) and cardiovascular death/HF hospitalization (HR 1.18;1.02-1.37; p = 0.022). At multivariable analysis women and men share as predictors of HF diabetes, history of cancer, chronic kidney disease, atrial fibrillation, complete revascularization and left ventricular ejection fraction. Chronic obstructive pulmonary disease (HR 2.34;1.70-3.22, p < 0.001) and diuretics treatment (HR 1.61;1.27-2.04, p < 0.001) were predictor of HF in men, while history of previous MI (HR 1.46;1.08-1.97, p = 0.015) and treatment with inhibitors of renin-angiotensin system (HR 0.69;0,49-0.96 all 95% CI, p = 0.030) in women. CONCLUSIONS: Women are at increased risk of HF after ACS and gender seems to be an outcome-modifier of the relationship between a variable and primary outcome.
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PMID : 38061607
DOI : 10.1016/j.ijcard.2023.131622
Keywords
Sex; Gender; Heart failure; Acute coronary syndrome; Ventricular Function, Left; Stroke Volume; Sex Factors; Retrospective Studies; Registries; Myocardial Infarction/epidemiology; Percutaneous Coronary Intervention/adverse effects; Heart Failure/diagnosis/epidemiology/etiology; Acute Coronary Syndrome/diagnosis/epidemiology/complications; Diabetes Mellitus/etiology; Male; Humans; Female; Women;