Left ventricular remodelling after ST-segment elevation myocardial infarction: sex differences and prognosis

Pieter van der Bijl, Rachid Abou, Laurien Goedemans, Bernard J. Gersh, David R. Holmes, Nina Ajmone Marsan, Victoria Delgado, Jeroen J. Bax

Research output: Contribution to journalArticle

Abstract

Aims: Left ventricular (LV) remodelling after ST-segment elevation myocardial infarction (STEMI) worsens outcome. The effect of sex on LV post-infarct remodelling is unknown. We therefore investigated the sex distribution and long-term prognosis of LV post-infarct remodelling after STEMI in the contemporary era of primary percutaneous coronary intervention (PCI) and optimal pharmacotherapy. Methods and results: Data were obtained from an ongoing primary PCI STEMI registry. LV remodelling was defined as ≥20% increase in LV end-diastolic volume at either 3, 6, or 12 months post-infarct, and LV remodelling impact on outcome was evaluated with a log-rank test. A total population of 1995 STEMI patients were analysed (mean age 60 ± 12 years): 1527 (77%) men and 468 (23%) women. The mean age of male patients was 60±11 versus 63±13 years for women (P < 0.001). A total of 953 (48%) patients experienced LV remodelling in the first 12 months of follow-up, and it was equally frequent amongst men (n = 729, 48%) and women (n = 224, 48%). After a median follow-up of 94 (interquartile range 69–119) months, 225 patients died: 171 (11%) men and 54 (12%) women. No survival difference was seen between remodellers and non-remodellers in the male (P = 0.113) and female (P = 0.920) groups. Conclusion: LV post-infarct remodelling incidence, as well as long-term survival of LV remodellers and non-remodellers, was similar in men and women who were treated with primary PCI and optimal pharmacotherapy post-STEMI.

Original languageEnglish (US)
Pages (from-to)474-481
Number of pages8
JournalESC Heart Failure
Volume7
Issue number2
DOIs
StatePublished - Apr 1 2020

Keywords

  • LV remodelling
  • Post-infarct
  • Prognosis
  • Sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Left ventricular remodelling after ST-segment elevation myocardial infarction: sex differences and prognosis'. Together they form a unique fingerprint.

  • Cite this

    van der Bijl, P., Abou, R., Goedemans, L., Gersh, B. J., Holmes, D. R., Ajmone Marsan, N., Delgado, V., & Bax, J. J. (2020). Left ventricular remodelling after ST-segment elevation myocardial infarction: sex differences and prognosis. ESC Heart Failure, 7(2), 474-481. https://doi.org/10.1002/ehf2.12618