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The sex difference in 6-month MACEs and its explaining variables in acute myocardial infarction survivors: Data from CPACS-3 study.

Abstract：

BACKGROUND:We aimed to assess sex difference in developing major adverse cardiovascular events (MACEs) after discharge and factors associated with the gender disparity among AMI survivors. METHODS:We selected the patients hospitalized with either NSTEMI or STEMI from 101 Chinese centers in the CPACS 3 study. We compared sex differences in MACEs and mortality in 6 months after discharge using a Cox proportional hazards model, following sequential adjustment for covariates. RESULTS:8958 patients with AMI were included and 30.3% were women. Overall, the crude rate of MACEs at 6 month for women were significantly higher than men (6.5% vs 4.5%; hazard ratio (HR) =1.47; 95% CI, 1.21-1.77). Women also had significantly higher total mortality compared to men (4.4% vs 2.7%; HR = 1.65; 95% CI, 1.30-2.09). Among possible explanatory factors, patients' cardiovascular risk profile might explain 53%, age 38%, low level of education and socioeconomic status 32%. Interestingly, medications at discharge did not contribute to the sex disparity in 6-month risk of MACEs. These factors could explain a similar proportion of the gender disparity in total death. All together, these factors could explain all the disparity in the risk of both MACEs (HR = 1.05,95% CI, 0.85-1.31) and total death (HR = 1.00,95% CI,0.76-1.30). CONCLUSIONS:The gender disparity in MACEs and total death among AMI patients continues at 6 months after discharged surviving. Multiple factors could explain the higher risk for women, including poorer cardiovascular risk factor profile, older age and lower socioeconomic status. TRIAL REGISTRATION:CPACS-3 was registered on www.clinicaltrails.gov, and the registration number is NCT01398228.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Sun Y,Feng L,Li X,Gao R,Wu Y

doi

10.1016/j.ijcard.2020.03.043

subject

Has Abstract

pub_date

2020-07-15 00:00:00

pages

1-6

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(20)30233-3

journal_volume

311

pub_type

杂志文章

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