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Weizman O, Tea V, Marijon E, Eltchaninoff H, Manzo-Silberman S, Leclercq F, Albert F, Bataille V, Drouet E, Naccache N, Puymirat E, Ferrières J, Schiele F, Simon T, Danchin N. Very long-term outcomes after acute myocardial infarction in young men and women: Insights from the FAST-MI program. Arch Cardiovasc Dis 2023; 116:324-334. [PMID: 37391340 DOI: 10.1016/j.acvd.2023.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 07/02/2023]
Abstract
AIMS Conflicting data exists about long-term outcomes in young women and men experiencing acute myocardial infarction (AMI). METHODS The FAST-MI program consists of three nationwide French surveys carried out 5years apart from 2005 to 2015, including consecutive patients with AMI over a 1-month period with up to 10-year follow-up. The present analysis focused on adults≤50 yo according to their gender. RESULTS Women accounted for 17.5% (335) of the 1912 patients under 50 yo and had a similar age as men (43.9±5.1 vs. 43.9±5.5years, P=0.92). They received less percutaneous coronary interventions (PCI) than men (85.9% vs. 91.3%, P=0.005), even in ST-elevation myocardial infarction (83.6% vs. 93.5%, P<0.001). Recommended secondary prevention medications were less frequently prescribed at discharge in women (40.6% vs. 52.8%, P<0.001), a trend that persisted in 2015 (59.1% vs. 72.8% in 2015, P<0.001). Still, ten-year survival was similar in men (90.5%) and women (92.3%) (crude HR: 0.86 [95% CI: 0.55-1.35], P=0.52, adjusted HR: 0.63 [95% CI: 0.38-1.07], P=0.09); similar results were found for ten-year survival among hospital survivors (91.2% in men vs. 93.7% in women, adjusted HR: 0.87 [95% CI: 0.45-1.66], P=0.66). Of the 1684 patients alive at hospital discharge with morbidity follow-up≥6months available, death, AMI or stroke at 8years occurred in 12.9% men and 11.2% in women (adjusted HR: 0.90 [95% CI: 0.60-1.33], P=0.59). CONCLUSIONS Young women with AMI undergo less cardiac interventions and are less often prescribed secondary prevention treatment than men, even when significant coronary artery disease is present, but keep a similar long-term prognosis after AMI. Optimal management of these young patients, regardless of gender, is necessary to ensure best outcomes after this major cardiovascular event.
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Affiliation(s)
- Orianne Weizman
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France
| | - Victoria Tea
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France
| | - Eloi Marijon
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France
| | - Hélène Eltchaninoff
- Normandie Université, UNIROUEN, U1096, CHU Rouen, Department of Cardiology, 76000 Rouen, France
| | - Stéphane Manzo-Silberman
- Institut de Cardiologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France; Sorbonne Université, ACTION Study Group, Paris, France
| | - Florence Leclercq
- Centre Hospitalier Universitaire Arnaud-de-Villeneuve, Montpellier, France
| | | | - Vincent Bataille
- Toulouse University Hospital, Department of Cardiology B and Epidemiology, Toulouse, France; UMR INSERM 1027, Toulouse, France
| | - Elodie Drouet
- AP-HP, Hôpital Saint-Antoine, Department of Clinical Pharmacology and Unité de Recherche Clinique (URCEST), Paris, France; Université Pierre-et-Marie-Curie (UPMC-Paris 06), INSERM U-698, Paris, France
| | | | - Etienne Puymirat
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France
| | - Jean Ferrières
- Toulouse University Hospital, Department of Cardiology B and Epidemiology, Toulouse, France; UMR INSERM 1027, Toulouse, France
| | - François Schiele
- University Hospital Jean-Minjoz, Department of Cardiology, Besançon, France
| | - Tabassome Simon
- AP-HP, Hôpital Saint-Antoine, Department of Clinical Pharmacology and Unité de Recherche Clinique (URCEST), Paris, France; Université Pierre-et-Marie-Curie (UPMC-Paris 06), INSERM U-698, Paris, France
| | - Nicolas Danchin
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France.
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