OBJECTIVES

Aim was to examine the relationship between gender and HF after STEMI in patients with no prior history of HF.

METHODS

A literature review was performed. Only publications looking at gender difference for HF in STEMI and including at least 500 women were retained. No other restriction was applied.

RESULTS

5 publications were identified.

The most recent publication (10’443 patients - 3,112 women) concluded that, after covariate adjustment for risk factors, HF at hospital presentation was significantly higher for women (25.1% vs 20.0% ; OR: 1.34; 95% CI : 1.21 - 1.48), with a higher 30-day mortality (25.1% vs 20.6% ; OR: 1.29 ; 95% CI: 1.05 - 1.58).

A study linking administrative databases in Alberta (45’064 patients, 45.1% STEMI , 30.8% women) showed that STEMI women had a higher unadjusted rate of developing in-hospital HF (15.2% vs 9.5%); This difference remained significant after adjustment (aOR : 1.26 ; 95% CI : 1.13–1.4). After 1 year and 5 years, women remained at higher risk of developing HF with adjusted subdistribution hazard ratios of 1.21 (95% CI : 1.12–1.3) and 1.18 (95% CI : 1.11–1.24), respectively.

In Poland, for STEMI patients with incomplete reperfusion after pPCI (766 (35%), rehospitalization because of HF was significantly higher in women at 6 months (12.5 % vs 7.5%, p = 0.016), 12 months (13.9% vs 9.4%, p = 0.044) and at 2 years (18.8% vs 11.7%, p= 0.006).

In a pooled patient-level data from 10 randomized pPCI trials (2’632 STEMI patients), women (23% of patients) had a higher 1-year rate HF hospitalization (5.6% vs 1.7% ; p < 0.0001).

This contrasts with a in Singapore with 7’597 STEMI patients (13.8% women). After adjusting for baseline characteristics and treatment, gender difference in risk of 1-year rehospitalization for HF was almost inexistent (HR : 1.05 ; 95% CI : 0.79 to 1.40).

CONCLUSIONS

Women appear to be at higher risk of developing de novo HF after STEMI.