Sex-based differences in heart failure development during STEMI hospitalization
Authors' conclusion
Women with ST-segment elevation myocardial infarction admitted in Killip class I had a higher risk of developing in-hospital HF. However, HF had a similar impact on in-hospital mortality in both sexes.
Study context
- Population
- STEMI patients; primary analysis in patients admitted in Killip class ISTEMI patients (22.9% women), 985 admitted in Killip class I · admitted in Killip class I 985
- Participants
- 1,279 patients
- Exposure
- Sex-specific differences in the development of in-hospital heart failure (HF)
- Outcome
- Development of HF during hospitalization in patients initially classified as Killip class I
- Follow-up
- During hospitalization
Methodological detailssix teaching hospitals
- Six teaching hospitals
Main finding
As reported in the abstract
P < 0.001
- Developed HF during hospitalization, of the 985 admitted in Killip class I
- 45 (4.6%)
Observational data: associations, not effects.
Secondary outcomes
HF at admission
P < 0.001
- HF at admission — Presented with HF at admission, of 1279
- 201 (15.8%)
Factors independently associated with in-hospital HF development (multi-variable logistic regression)
- Female sex OR (95% CI)
- 3.09; 1.46-6.53
- Multi-vessel disease OR (95% CI)
- 2.19; 1.06-4.56
- Out-of-hospital cardiac arrest OR (95% CI)
- 4.76; 1.04-21.71
- Higher left ventricular ejection fraction (protective) OR (95% CI)
- 0.92; 0.87-0.93
- Age and final TIMI flow <3 not associated
In-hospital mortality (secondary outcome)
- HF linked to increased mortality in men
- Sex-mortality interaction P = 0.108
Original publication
Sex-based differences in heart failure development during STEMI hospitalization. Eur Heart J Qual Care Clin Outcomes. Published 31 October 2025. doi:10.
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