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Myocardial infarction and gender differences in elderly patients
Session:
SESSÃO DE POSTERS 17 - DIFERENÇAS ENTRE SEXOS NA MEDICINA CARDIOVASCULAR
Speaker:
Gonçalo Rm Ferreira
Congress:
CPC 2025
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.2 Cardiovascular Disease in Women
Session Type:
Cartazes
FP Number:
---
Authors:
Gonçalo Rm Ferreira; João Fiúza Gouveia; Oliver Kungel; Francisco Santos; Mariana Almeida; Vanda Neto; Luísa Gonçalves; Júlio Gil; Bruno Marmelo; António Costa
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">BACKGROUND</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">Myocardial infarction remains a main cause of death in western countries. Clinical trials that supply scientific evidence behind the guidelines usually exclude the elderly and underrepresent female patients. Furthermore, new studies suggest that these patients are less likely to receive guideline-oriented treatment and therefore are at higher risk of adverse events during hospitalization.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">PURPOSE</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">Compare gender differences in the initial management of older patients presenting with ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">METHODS</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">Enrolled patients with the age of 65 or older, admitted in the cardiology department with the diagnosis STEMI and NSTEMI during 2007 and 2015. Excluded patients who underwent thrombolysis. Patients were divided in two groups: STEMI group and NSTEMI group.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">In each group, comparison between genders was made in terms of percutaneous coronary intervention (PCI) versus conservative approach, timing of PCI (urgent versus delayed), and in-hospital cardiovascular outcomes (cardiovascular death and heart failure).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">For statistical analysis, the two groups were compared using Pearson’s Chi-Square test and odds-ratio chances, considering p values <0.05 to be statistically significant.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">RESULTS</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">The study cohort was composed 382 patients in the STEMI group, and 621 patients for NSTEMI group.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">In the STEMI group, 36.4% of the patients were female. Female patients were older than male patients (mean age of 78.2 years vs 75.8 years), and cardiovascular risk factors were prevalent in the former. There was no difference in the choice of conservative treatment (17.3% females vs 16% males, p=0.78) and in the timing of PCI (delayed PCI in 16.5% females vs 15.2% males, p=0.75). In terms of adverse events, no difference between genders in in-hospital mortality or heart failure.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">In the NSTEMI group, 37.5% of the patients were female. Female patients were older than male patients (mean age of 79 years vs 76.2 years), and arterial hypertension, dyslipidemia and obesity were prevalent in the former. Female patients were 1.48 times more likely to receive conservative treatment vs male patients (45.4% females vs 36% males, p=0,02). However, there was no difference between genders in in-hospital mortality or heart failure, even in the conservative approach subgroup. There was no difference in the timing of PCI (delayed PCI in 94.1% females vs 94.4% males, p=0,91). </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">DISCUSSION</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><span style="font-family:"Times New Roman","serif"">There was no difference in the initial management of STEMI elderly patients, regardless of gender. Although female elderly patients presenting with NSTEMI were more likely to receive conservative treatment, there was no difference in adverse outcomes during hospitalization.</span></span></span></p>
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