Journal Article

Prospective Comparison of Temporal Myocardial Function in Men Versus Women After Anterior ST-Elevation Myocardial Infarction With Timely Reperfusion

Bobbio, Emanuele, Poller, Angela, Thorleifsson, Sigurdur, Omerovic, Elmir, Torild, Petronella, Redfors, Bjorn, Angerås, Oskar, Pirazzi, Carlo, Mellberg, Tomas, Salahuddin, Sabin, Sevastianova, Valentyna, Gudmundsson, Thorsteinn, Sundstrom, Joakim, Ramunddal, Truls, Elmahdy, Ahmed, Shekka Espinosa, Aaron, Andersson, Erik Axel, Pylova, Tetiana, Jha, Sandeep, Zeijlon, Rickard, Baranowska, Julia, Martinsson, Andreas, Molander, Linnea, Skoglund, Kristofer, Simons, Koen

2025

Overview

Compared to men, women have been reported to have increased morbidity and mortality after ST-elevation myocardial infarction (STEMI); but sex differences in cardiac function in the acute and subacute phases of STEMI are incompletely understood. The objective of this study was to prospectively compare changes in cardiac function over the acute and subacute phases after anterior STEMI with timely reperfusion in women versus men. The Stunning in Takotsubo versus Acute Myocardial Infarction (STAMI) study (NCT04448639) prospectively enrolled 105 men and 41 women with anterior STEMI. Echocardiography and blood sampling were performed within 4 hours of admission and at 1, 2, 3, 7, 14, and 30 days after admission. The primary outcome was akinesia recovery, defined as the difference in the percentage of akinesia observed at baseline versus follow-up. Secondary outcomes included wall motion score index (WMSI), left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). Mixed effects linear regression or zero-inflated tobit models with random intercepts were used to model echocardiographic parameters over time. Baseline patient characteristics were similar in both groups. The difference between women and men in akinesia recovery at 30 days was 8.3% (95% credible interval 0.8%, 15.5%). The covariate-adjusted posterior probability that akinesia recovery and WMSI improvement at 30 days are greater in women than men were 96.0% and 99.0% respectively. Similar but less pronounced trends towards greater improvement in women than men were observed for LVEF and GLS. In conclusion, cardiac dysfunction recovered to a greater extent in women than in men after anterior STEMI with timely reperfusion.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Aged / Akinesia / Anterior Wall Myocardial Infarction - physiopathology / Cardiology and Cardiovascular Disease / Chronic obstructive pulmonary disease / Clinical outcomes / Conditional probability / Diabetes / Echocardiography / Electrocardiography / Female / Follow-Up Studies / Gender differences / Heart attacks / Humans / Hypertension / Kardiologi och kardiovaskulära sjukdomar / Male / Men / Middle Aged / Morbidity / Mortality / myocardial function / Myocardial infarction / Myocardial Reperfusion - methods / Normal distribution / Patients / Percutaneous Coronary Intervention / Prospective Studies / Recovery / Recovery of Function / Regression analysis / Reperfusion / Sensitivity analysis / Sex differences / Sex Factors / ST Elevation Myocardial Infarction - diagnostic imaging / ST Elevation Myocardial Infarction - physiopathology / ST Elevation Myocardial Infarction - surgery / ST Elevation Myocardial Infarction - therapy / ST-elevation myocardial infarction (STEMI) / Statistical analysis / Stroke Volume - physiology / Time Factors / Variables / Ventricular Function, Left - physiology / Women