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Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients - Data from the CHILL-MI, MITOCARE and SOCCER trials

Nordlund, David LU ; Engblom, Henrik LU ; Bonnet, Jean Louis ; Hansen, Henrik Steen ; Atar, Dan ; Erlinge, David LU ; Ekelund, Ulf LU ; Heiberg, Einar LU ; Carlsson, Marcus LU and Arheden, Håkan LU (2019) In BMC Cardiovascular Disorders 19(1).
Abstract

Background: Infarct evolution rate and response to acute reperfusion therapy may differ between patients, which is important to consider for accurate management and treatment of patients with ST-elevation myocardial infarction (STEMI). The aim of this study was therefore to investigate the association of infarct size and myocardial salvage with gender, smoking status, presence of diabetes or history of hypertension in a cohort of STEMI-patients. Methods: Patients (n = 301) with first-time STEMI from the three recent multi-center trials (CHILL-MI, MITOCARE and SOCCER) underwent cardiac magnetic resonance (CMR) imaging to determine myocardium at risk (MaR) and infarct size (IS). Myocardial salvage index (MSI) was calculated as MSI =... (More)

Background: Infarct evolution rate and response to acute reperfusion therapy may differ between patients, which is important to consider for accurate management and treatment of patients with ST-elevation myocardial infarction (STEMI). The aim of this study was therefore to investigate the association of infarct size and myocardial salvage with gender, smoking status, presence of diabetes or history of hypertension in a cohort of STEMI-patients. Methods: Patients (n = 301) with first-time STEMI from the three recent multi-center trials (CHILL-MI, MITOCARE and SOCCER) underwent cardiac magnetic resonance (CMR) imaging to determine myocardium at risk (MaR) and infarct size (IS). Myocardial salvage index (MSI) was calculated as MSI = 1-IS/MaR. Pain to balloon time, culprit vessel, trial treatments, age, TIMI grade flow and collateral flow by Rentrop grading were included as explanatory variables in the statistical model. Results: Women (n = 66) had significantly smaller MaR (mean difference: 5.0 ± 1.5% of left ventricle (LV), p < 0.01), smaller IS (mean difference: 5.1 ± 1.4% of LV, p = 0.03), and larger MSI (mean difference: 9.6 ± 2.8% of LV, p < 0.01) compared to men (n = 238). These differences remained significant when adjusting for other explanatory variables. There were no significant effects on MaR, IS or MSI for diabetes, hypertension or smoking. Conclusions: Female gender is associated with higher myocardial salvage and smaller infarct size suggesting a pathophysiological difference in infarct evolution between men and women.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Area at risk, Diabetes, Gender, Hypertension, Sex
in
BMC Cardiovascular Disorders
volume
19
issue
1
article number
161
publisher
BioMed Central (BMC)
external identifiers
  • pmid:31269907
  • scopus:85068598237
ISSN
1471-2261
DOI
10.1186/s12872-019-1139-7
language
English
LU publication?
yes
id
f3500ddb-6bda-4f97-ba79-c6fc589619e7
date added to LUP
2019-07-16 14:13:25
date last changed
2020-01-13 02:13:57
@article{f3500ddb-6bda-4f97-ba79-c6fc589619e7,
  abstract     = {<p>Background: Infarct evolution rate and response to acute reperfusion therapy may differ between patients, which is important to consider for accurate management and treatment of patients with ST-elevation myocardial infarction (STEMI). The aim of this study was therefore to investigate the association of infarct size and myocardial salvage with gender, smoking status, presence of diabetes or history of hypertension in a cohort of STEMI-patients. Methods: Patients (n = 301) with first-time STEMI from the three recent multi-center trials (CHILL-MI, MITOCARE and SOCCER) underwent cardiac magnetic resonance (CMR) imaging to determine myocardium at risk (MaR) and infarct size (IS). Myocardial salvage index (MSI) was calculated as MSI = 1-IS/MaR. Pain to balloon time, culprit vessel, trial treatments, age, TIMI grade flow and collateral flow by Rentrop grading were included as explanatory variables in the statistical model. Results: Women (n = 66) had significantly smaller MaR (mean difference: 5.0 ± 1.5% of left ventricle (LV), p &lt; 0.01), smaller IS (mean difference: 5.1 ± 1.4% of LV, p = 0.03), and larger MSI (mean difference: 9.6 ± 2.8% of LV, p &lt; 0.01) compared to men (n = 238). These differences remained significant when adjusting for other explanatory variables. There were no significant effects on MaR, IS or MSI for diabetes, hypertension or smoking. Conclusions: Female gender is associated with higher myocardial salvage and smaller infarct size suggesting a pathophysiological difference in infarct evolution between men and women.</p>},
  author       = {Nordlund, David and Engblom, Henrik and Bonnet, Jean Louis and Hansen, Henrik Steen and Atar, Dan and Erlinge, David and Ekelund, Ulf and Heiberg, Einar and Carlsson, Marcus and Arheden, Håkan},
  issn         = {1471-2261},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Cardiovascular Disorders},
  title        = {Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients - Data from the CHILL-MI, MITOCARE and SOCCER trials},
  url          = {http://dx.doi.org/10.1186/s12872-019-1139-7},
  doi          = {10.1186/s12872-019-1139-7},
  volume       = {19},
  year         = {2019},
}