Sex- and age-related differences in outcomes of patients with acute myocardial infarction: MINOCA vs. MIOCA
Authors' conclusion
MINOCA females ≤70 years old had a significantly higher incidence of MAE, compared with males and MIOCA female peers, likely due to the different pathophysiology of the ischaemic event.
Study context
- Population
- Patients with acute myocardial infarction (AMI) undergoing coronary angiography, January 2017 to September 2021
- Participants
- 2,455 patients
- Exposure
- Females vs males, in MINOCA and MIOCA
- MIOCA malen = 1,593reference
- MIOCA femalen = 607
- MINOCA malen = 87reference
- MINOCA femalen = 168
- Outcome
- MAE: composite of all-cause death, recurrent AMI and HF hospitalisation
- Follow-up
- Median 28 (15-41) months
Main finding
As reported in the abstract
MAE (all-cause death, recurrent AMI or HF hospitalization), unadjusted incidence
MINOCA females vs MINOCA males: P = 0.018 · MIOCA females vs MIOCA males: P = 0.002
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| MAE, MINOCA aged ≤70 years (subgroup)Female sex as independent predictor; only in this subgroup | 3.09 (1.02–9.59) | P = 0.040 | |
| 0.10.31310Hazard ratio (log scale) |
| Outcome | MINOCA male | MINOCA female | P value |
|---|---|---|---|
| MAE, MINOCA aged ≤70 years (subgroup)Unadjusted | 5.9% | 23.7% | P = 0.003 |
- MAE, MINOCA aged ≤70 years (subgroup) — Driven by higher heart failure (HF) re-hospitalisation
- P = 0.045
- MAE, MINOCA aged ≤70 years (subgroup) — Driven by higher recurrent AMI
- P = 0.006
MAE, MINOCA aged ≤70 years (subgroup)
- MINOCA females ≤70 years had worse outcomes than MIOCA female peers
Original publication
Sex- and age-related differences in outcomes of patients with acute myocardial infarction: MINOCA vs. MIOCA. Eur Heart J Acute Cardiovasc Care. Published 1 June 2023. doi:10.
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