LAUSR

Myocardial infarction (MI) remains the most common cause of heart failure (HF). Data on sex-related critical state in patients with MI who underwent PCI and their long-term outcome, are missing. We evaluated whether there is a sex difference in critical state and if sex is associated with long-term survival in these patients. We defined critical state as cardiogenic shock and/or mechanical ventilation and/or intra-aortic balloon pump and/or ejection fraction≤30%. We analyzed data on 5669 patients with MI treated with percutaneous interventions (PCI). The criteria for critical state were fulfilled by 539 (9.5%) patients, of whom 172 (31.9%) were women. Long-term mortality was observed. The median follow-up time was 5.0 (25th, 75th percentile: 3,8) years. Data were analyzed using descriptive statistics. The incidence of critical state was similar in both sexes [172 (9.8%) women compared to 367 (9.4%) men]. The women were older, suffered more diabetes and renal dysfunction, presented more often in cardiogenic shock, and had a higher maximal troponin/body surface area level. After adjustment, female sex was associated with critical state (adjusted OR 1.38; 95% CI 1.07 to 1.77; p=0.013). However, similar unadjusted long-term mortality was observed [111 (64.5%) of women died compared to 244 (66.5%) men, p=0.70]. Furthermore, after adjustment for potential confounders, female sex was associated with a 24% lower risk of dying in the long term (adjusted HR 0.76; 95% CI 0.58 to 0.98; p=0.037) compared to men (Figure 1). Other predictors of long-term mortality in patients with critical state were age, hyperlipidemia, renal dysfunction, and dual antiplatelet therapy. Figure 1 Female sex was associated with critical state. However, the unadjusted long-term mortality was similar in both sexes. In addition, female sex was associated with better long-term survival in patients with critical state. Further investigation is required to answer these associations.