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Jiao J, Feng X, Gong A, Yao Y. Association between reproductive lifespan and multimorbidity among Chinese postmenopausal women. Menopause 2024:00042192-990000000-00357. [PMID: 39078652 DOI: 10.1097/gme.0000000000002419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
OBJECTIVE Although menopause is considered a risk factor for multimorbidity, few studies have explored the association between reproductive lifespan and multimorbidity. This study aimed to explore the association between reproductive lifespan and multimorbidity in postmenopausal Chinese women. METHODS This cross-sectional study selected postmenopausal women as study participants. The reproductive lifespan refers to the interval between menarche and menopause. Multimorbidity refers to having two or more self-reported chronic diseases. We used a logistic regression model to explore potential associations based on the adjustment of a set of covariates. RESULTS In total, 1,310 postmenopausal women with an average reproductive lifespan of 34 years were included in this study. The prevalence of multimorbidity was 22.2% (291/1,310) in postmenopausal women. Our findings showed that compared with postmenopausal women with the Q1 of reproductive lifespan (≤32 reproductive years), those with Q3 (35-37 reproductive years) and Q4 (≥38 reproductive years) were less likely to have multimorbidity (ORQ3 = 0.529, 95% CIQ3 = 0.347-0.805, ORQ4 = 0.510, 95% CIQ4 = 0.308-0.842), whereas those with Q2 (33-34 reproductive years) were not (OR = 0.700, 95% CI = 0.446-1.098). This study also revealed a linear trend in the association between the reproductive lifespan and multimorbidity; that is, the longer the reproductive lifespan, the lower the risk of multimorbidity. CONCLUSIONS In postmenopausal Chinese women, a longer reproductive lifespan was associated with a lower prevalence of multimorbidity. This study suggests that for the prevention and intervention of multimorbidity in postmenopausal women, healthcare professionals should screen and assess reproductive factors to identify high-risk individuals.
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Affiliation(s)
- Jiao Jiao
- From the Department of Reproductive Medicine, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuehua Feng
- From the Department of Reproductive Medicine, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ailing Gong
- Yinan County Maternal and Child Health Hospital, Linyi, China
| | - Yi Yao
- From the Department of Reproductive Medicine, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Sudjono C, Hanna Quinncilla K, Qonita M, Jason Wijaya N, Kurnain DN. Early Menarche as a Protective Factor Against Cardiovascular Events: A Systematic Review and Meta-analysis. Anatol J Cardiol 2024; 28:329-338. [PMID: 38940409 PMCID: PMC11230583 DOI: 10.14744/anatoljcardiol.2024.3996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/16/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Women are often neglected in cardiovascular health prevention. Age at menarche (AAM) has been linked to cardiovascular (CVD) disease in women and is potentially identified as one of the significant CVD risk factor. However, there is still limited comprehensive evidence addressing this issue. This systematic review and meta-analysis aimed to investigate how early menarche affects the outcome of all-cause mortality, CVD mortality, total cardiovascular disease event, stroke (ischemic, hemorrhagic, and total stroke), and coronary heart disease (CHD). METHOD The Cochrane Library, MEDLINE, Embase, ScienceDirect, and Google Scholar databases were searched from March 2013 to March 2023 for cohorts investigating the effect of early onset of menarche on CVD events with a minimum follow-up period of 5 years. Studies that observed specific population and/or included women with a history of CVD at baseline were excluded. The Newcastle-Ottawa scale was used for risk of bias assessment for each cohort included. The data were presented as dichotomous measure using risk ratios. I2 statistics were utilized to evaluate the heterogeneity of presented data. RESULTS Thirteen cohorts included 18 626 799 female patients with ages ranging from 43 to 62.6 years. These reported 6 estimates each for CHD (5 483 298 patients) and all-cause mortality (1 595 878 patients), 5 estimates each for total stroke (2 941 321 patients) and CVD mortality (1 706 742 patients), 4 estimates each for total CVD events (3 988 311 patients) and ischemic stroke (2 434 580 patients), and 1 estimate for hemorrhagic stroke (66 104 patients). Our study found that events of CHD were significantly lower in early menarche (RR 0.57; 95% CI 0.41-0.78; P <.00001), as well as total stroke (RR 0.51; 95% CI 0.35-0.73; P =.0003), CVD mortality (RR 0.47; 95% CI 0.22-0.98; P =.04), total CVD events (RR 0.44; 95% CI 0.25-0.76; P =.003), ischemic stroke (RR 0.31; 95% CI 0.15-0.61; P <.0008), and hemorrhagic stroke (RR 0.12; 95% CI 0.07-0.20; P <.00001); and insignificantly higher in all-cause mortality (RR 0.90, 95% CI 0.76-1.06, P =.20). CONCLUSION In our study, cardiovascular events are lower in women with early menarche; hence, the later age of menarche is a potential risk factor to be considered when assessing CVD risk in a patient. However, our sample characteristics were heterogenous, and we did not consider other female hormonal factors that might potentially contribute to the CVD outcomes observed; thus, further studies are needed to clarify.
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Affiliation(s)
- Clinton Sudjono
- Department of Cardiology, Faculty of Medicine, Tarumanagara University, Jakarta, Indonesia
| | | | - Ms Qonita
- Jenderal Soedirman University, Purwokerto, Indonesia
| | - Nicholas Jason Wijaya
- Undergraduate Medical Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Dave Nicander Kurnain
- Department of Cardiology, Faculty of Medicine, Tarumanagara University, Jakarta, Indonesia
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Lucà F, Pavan D, Gulizia MM, Manes MT, Abrignani MG, Benedetto FA, Bisceglia I, Brigido S, Caldarola P, Calvanese R, Canale ML, Caretta G, Ceravolo R, Chieffo A, Chimenti C, Cornara S, Cutolo A, Di Fusco SA, Di Matteo I, Di Nora C, Fattirolli F, Favilli S, Francese GM, Gelsomino S, Geraci G, Giubilato S, Ingianni N, Iorio A, Lanni F, Montalto A, Nardi F, Navazio A, Nesti M, Parrini I, Pilleri A, Pozzi A, Rao CM, Riccio C, Rossini R, Scicchitano P, Valente S, Zuccalà G, Gabrielli D, Grimaldi M, Colivicchi F, Oliva F. Italian Association of Hospital Cardiologists Position Paper 'Gender discrepancy: time to implement gender-based clinical management'. Eur Heart J Suppl 2024; 26:ii264-ii293. [PMID: 38784671 PMCID: PMC11110461 DOI: 10.1093/eurheartjsupp/suae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
It has been well assessed that women have been widely under-represented in cardiovascular clinical trials. Moreover, a significant discrepancy in pharmacological and interventional strategies has been reported. Therefore, poor outcomes and more significant mortality have been shown in many diseases. Pharmacokinetic and pharmacodynamic differences in drug metabolism have also been described so that effectiveness could be different according to sex. However, awareness about the gender gap remains too scarce. Consequently, gender-specific guidelines are lacking, and the need for a sex-specific approach has become more evident in the last few years. This paper aims to evaluate different therapeutic approaches to managing the most common women's diseases.
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Affiliation(s)
- Fabiana Lucà
- Cardiology Department, Grande Ospedale Metropolitano GOM, Reggio Calabria, Via Melacriono, 1, 89129 Reggio, Calabria, Italy
| | - Daniela Pavan
- Cardio-Cerebro-Rehabilitation Department, Azienda Sanitaria Friuli Occidentale, (AS FO) Via della Vecchia Ceramica, 1, Pordenone 33170, Italy
| | - Michele Massimo Gulizia
- Cardiology Unit, Cardiology Spoke Cetraro-Paola, San Franceco di paola Hospital, 87027 Paola, CS, Italy
| | - Maria Teresa Manes
- Cardiology Unit, Cardiology Spoke Cetraro-Paola, San Franceco di paola Hospital, 87027 Paola, CS, Italy
| | | | - Francesco Antonio Benedetto
- Cardiology Department, Grande Ospedale Metropolitano GOM, Reggio Calabria, Via Melacriono, 1, 89129 Reggio, Calabria, Italy
| | - Irma Bisceglia
- Cardio-Thoraco-Vascular Department, San Camillo Forlanini Hospital, 00152 Roma, Italy
| | - Silvana Brigido
- Cardiology Clinics, ‘F.’ Hospital Jaia’, 70014 Conversano, BA, Italy
| | | | | | | | - Giorgio Caretta
- Cardiology Unit, Sant’Andrea Hospital, 19100 La Spezia, SP, Italy
| | - Roberto Ceravolo
- Cardiology Division, Giovanni Paolo II Hospial, 88046 Lamezia Terme, CZ, Italy
| | - Alaide Chieffo
- Interventional Cardiology, IRCCS Ospedale San Raffaele, 20132 Milano, Italy
| | - Cristina Chimenti
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy
| | - Stefano Cornara
- Levante Cardiology, San Paolo Hospital, Savona, 17100 Savona, SV, Italy
| | - Ada Cutolo
- Cardiolog Unit, Ospedale dell’Angelo, 30172 Mestre, Italy
| | | | - Irene Di Matteo
- Cardiology Unit, Cariovascular Department, ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
| | - Concetta Di Nora
- Cardiac Surgery Unit, Santa Maria della Misericordia Hospital, 33100 Udine, UD, Italy
| | - Francesco Fattirolli
- Department of Experimental and Clinical Medicine, Florence University, 50121 Firenze, Italy
| | - Silvia Favilli
- Pediatric and Transition Cardiology Unit, Meyer University Hospital, 50139 Florence, Italy
| | - Giuseppina Maura Francese
- Cardiology Unit, Cardiology Spoke Cetraro-Paola, San Franceco di paola Hospital, 87027 Paola, CS, Italy
| | - Sandro Gelsomino
- Pediatric and Transition Cardiology Unit, Meyer University Hospital, 50139 Florence, Italy
| | - Giovanna Geraci
- Cardiology Unit, Sant'Antonio Abate di Erice, 91016 Erice, Trapani, Italy
| | | | | | - Annamaria Iorio
- Cardiology Unity 1, Cardiology 1, Cardiovascular Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
| | - Francesca Lanni
- Cardiology Unity, San Giuseppe Moscati Hospital, 83100 Avellino, Italy
| | - Andrea Montalto
- Cardiac Surgery Unit, San Camillo Forlanini Hospital, 00152 Roma, Italy
| | - Federico Nardi
- Dipartimento di Cardiologia, Ospedale Santo Spirito, Casale Monferrato, Italy
| | | | - Martina Nesti
- Cardiology Unity, San Donato Hospital, 52100 Arezzo, Italy
| | - Iris Parrini
- Cardiology Unity, Umberto I Di Torino Hospital, 10128 Torino, Italy
| | - Annarita Pilleri
- Federico Nardi, Cardiology Unit, Casale Monferrato Hospital, 15033 Casale Monferrato (AL), Italy
| | - Andrea Pozzi
- Cardiology Unity 1, Cardiology 1, Cardiovascular Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
| | - Carmelo Massimiliano Rao
- Cardiology Department, Grande Ospedale Metropolitano GOM, Reggio Calabria, Via Melacriono, 1, 89129 Reggio, Calabria, Italy
| | - Carmine Riccio
- Post-Acute Patient Follow-up Unit, Cardio-Vascular Department, AORN Sant'Anna and San Sebastiano, Caserta, Italy
| | | | | | - Serafina Valente
- Clinical-Surgical Cardiology, A.O.U. Siena, Santa Maria alle Scotte Hospital, 53100 Siena, Italy
| | - Giuseppe Zuccalà
- Department of Geriatrics, Center for Aging Medicine, Catholic University of the Sacred Heart and IRCCS Fondazione Policlinico A. Gemelli, 00168 Rome, Italy
| | - Domenico Gabrielli
- Dipartimento Cardio-Toraco-Vascolare, U.O.C. Cardiologia, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
- Fondazione per il Tuo cuore—Heart Care Foundation, 50121 Firenze, Italy
| | - Massimo Grimaldi
- Cardiology Division, Coronary Intensive Care Unit, Miulli Hospital, 70021 Acquaviva delle Fonti, Italy
| | | | - Fabrizio Oliva
- Cardiology Unit, Cariovascular Department, ‘A. De Gasperis’, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
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Behboudi-Gandevan S, Moe CF, Skjesol I, Arntzen EC, Bidhendi-Yarandi R. The J shaped association of age at menarche and cardiovascular events: systematic review and meta-analysis. Sci Rep 2024; 14:2695. [PMID: 38302648 PMCID: PMC10834967 DOI: 10.1038/s41598-024-53011-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/25/2024] [Indexed: 02/03/2024] Open
Abstract
This study aimed to evaluate the association between age at menarche and cardiovascular (CV) events through a systematic review and meta-analysis of observational studies. A comprehensive literature search covering studies published from January 1, 2000, to October 31, 2023, was conducted in PubMed, MEDLINE, Embase, and Scopus. Twenty-nine observational studies involving 4,931,160 adult women aged 18 years or older were included. The meta-analysis revealed a J-shaped association between age at menarche and CV events. Individuals with menarche at 12-13 years exhibited the lowest risk, while those with younger (≤ 11 years) or older ages (14-15 years and ≥ 16 years) showed an increased risk. Notably, individuals with age at menarche of 16 years and older had the highest risk of CV events. The pooled odds of CV mortality in age at menarche categories 14-15 years and ≥ 16 years were 37% (OR: 1.37, 95% CI 1.14-1.64, I2: 76.9%) and 64% (OR: 1.64, 95% CI 1.20-2.24, I2: 87%) higher than referent age at menarche 12-13 years. No statistically significant difference was found in CV mortality risk between individuals with age at menarche ≤ 11 years and those with age at menarche 12-13 years. The ORs for coronary heart disease were significantly higher for age at menarche ≥ 16 years (35% increase), while no significant difference was found for age at menarche ≤ 11 years or 14-15 years compared to age at menarche 12-13 years. Regarding stroke, the ORs for age at menarche ≤ 11, 14-15, and ≥ 16 years were significantly higher (7%, 24%, and 94% increase, respectively) compared to age at menarche 12-13 years. Dose-response meta-analysis and one-stage random-effect cubic spline models confirmed the J-shaped risk pattern. Meta-regression indicated that age and BMI were not significant sources of heterogeneity. Sensitivity analyses and the absence of publication bias further supported the robustness of the findings. This study concludes that age at menarche is independently associated with CV events, with a J-shaped pattern. The findings underscore the significance of considering menarche age as an independent risk factor for CV events. Further research is warranted to validate these findings and explore potential underlying mechanisms.
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Affiliation(s)
| | | | - Ingunn Skjesol
- Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway
| | - Ellen Christin Arntzen
- Faculty of Nursing and Health Sciences, Nord University, Post Box: 1490, 8049, Bodø, Norway
| | - Razieh Bidhendi-Yarandi
- Department of Biostatistics and Epidemiology, School of Social Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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5
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Wright ME, Murphy K. A mini-review of the evidence for cerebrovascular changes following gender-affirming hormone replacement therapy and a call for increased focus on cerebrovascular transgender health. Front Hum Neurosci 2023; 17:1303871. [PMID: 38077183 PMCID: PMC10702528 DOI: 10.3389/fnhum.2023.1303871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 10/31/2023] [Indexed: 02/12/2024] Open
Abstract
Gender-affirming hormone replacement therapy (gaHRT) is an important step for many in the gender diverse community, associated with increased quality-of-life and lower self-reported scores of depression and anxiety. However, considering the interactions that the involved sex hormones have on vasculature (with oestrogen and testosterone demonstrating vasodilatory and vasoconstricting properties, respectively), it is important for transgender healthcare research to examine how the manipulation of these hormones interact with cerebrovascular structure and functioning. There is a stark lack of research in this area. This mini-review outlines the research suggesting a vascular impact of these sex hormones using evidence from a range of cohorts (e.g., menopause, polycystic ovary syndrome) and discusses the work that has been done into cerebrovascular changes following gaHRT. Finally, recommendations for future research into cerebrovascular health in transgender cohorts following gaHRT are outlined.
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Affiliation(s)
- Melissa Emily Wright
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
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6
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Lin KH, Ramesh S, Agarwal S, Kuo WW, Kuo CH, Chen MYC, Lin YM, Ho TJ, Huang PC, Huang CY. Fisetin attenuates doxorubicin-induced cardiotoxicity by inhibiting the insulin-like growth factor II receptor apoptotic pathway through estrogen receptor-α/-β activation. Phytother Res 2023; 37:3964-3981. [PMID: 37186468 DOI: 10.1002/ptr.7855] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 03/17/2023] [Accepted: 04/15/2023] [Indexed: 05/17/2023]
Abstract
Doxorubicin (DOX), an effective chemotherapeutic drug, has been used to treat various cancers; however, its cardiotoxic side effects restrict its therapeutic efficacy. Fisetin, a flavonoid phytoestrogen derived from a range of fruits and vegetables, has been reported to exert cardioprotective effects against DOX-induced cardiotoxicity; however, the underlying mechanisms remain unclear. This study investigated fisetin's cardioprotective role and mechanism against DOX-induced cardiotoxicity in H9c2 cardiomyoblasts and ovariectomized (OVX) rat models. MTT assay revealed that fisetin treatment noticeably rescued DOX-induced cell death in a dose-dependent manner. Moreover, western blotting and TUNEL-DAPI staining showed that fisetin significantly attenuated DOX-induced cardiotoxicity in vitro and in vivo by inhibiting the insulin-like growth factor II receptor (IGF-IIR) apoptotic pathway through estrogen receptor (ER)-α/-β activation. The echocardiography, biochemical assay, and H&E staining results demonstrated that fisetin reduced DOX-induced cardiotoxicity by alleviating cardiac dysfunction, myocardial injury, oxidative stress, and histopathological damage. These findings imply that fisetin has a significant therapeutic potential against DOX-induced cardiotoxicity.
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Affiliation(s)
- Kuan-Ho Lin
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Samiraj Ramesh
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Research and Innovation, Institute of Biotechnology, Saveetha School of Engineering (SSE), Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, India
| | - Sakshi Agarwal
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Wei-Wen Kuo
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
| | - Chia-Hua Kuo
- Laboratory of Exercise Biochemistry, University of Taipei, Taipei, Taiwan
| | - Michael Yu-Chih Chen
- Department of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yueh-Min Lin
- Department of Medical Technology, Jen-The Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
- Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan
| | - Tsung-Jung Ho
- Department of Chinese Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Pei-Chen Huang
- Department of Obstetrics and Gynecology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Graduate Institute of Medical Science, China Medical University, Taichung, Taiwan
| | - Chih-Yang Huang
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Graduate Institute of Medical Science, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
- Center of General Education, Buddhist Tzu Chi Medical Foundation, Tzu Chi University of Science and Technology, Hualien, Taiwan
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Zhao P, Liu C, Zhang C, Hou Y, Zhang X, Zhao J, Sun G, Zhou J. Using Machine Learning to Predict the In-Hospital Mortality in Women with ST-Segment Elevation Myocardial Infarction. Rev Cardiovasc Med 2023; 24:126. [PMID: 39076750 PMCID: PMC11273031 DOI: 10.31083/j.rcm2405126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/28/2023] [Accepted: 02/03/2023] [Indexed: 07/31/2024] Open
Abstract
Background Several studies have shown that women have a higher mortality rate than do men from ST-segment elevation myocardial infarction (STEMI). The present study was aimed at developing a new risk-prediction model for all-cause in-hospital mortality in women with STEMI, using predictors that can be obtained at the time of initial evaluation. Methods We enrolled 8158 patients who were admitted with STEMI to the Tianjin Chest Hospital and divided them into two groups according to hospital outcomes. The patient data were randomly split into a training set (75%) and a testing set (25%), and the training set was preprocessed by adaptive synthetic (ADASYN) sampling. Four commonly used machine-learning (ML) algorithms were selected for the development of models; the models were optimized by 10-fold cross-validation and grid search. The performance of all-population-derived models and female-specific models in predicting in-hospital mortality in women with STEMI was compared by several metrics, including accuracy, specificity, sensitivity, G-mean, and area under the curve (AUC). Finally, the SHapley Additive exPlanations (SHAP) value was applied to explain the models. Results The performance of models was significantly improved by ADASYN. In the overall population, the support vector machine (SVM) combined with ADASYN achieved the best performance. However, it performed poorly in women with STEMI. Conversely, the proposed female-specific models performed well in women with STEMI, and the best performing model achieved 72.25% accuracy, 82.14% sensitivity, 71.69% specificity, 76.74% G-mean and 79.26% AUC. The accuracy and G-mean of the female-specific model were greater than the all-population-derived model by 34.64% and 9.07%, respectively. Conclusions A machine-learning-based female-specific model can conveniently and effectively identify high-risk female STEMI patients who often suffer from an incorrect or delayed management.
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Affiliation(s)
- Pengyu Zhao
- Department of Communication Engineering, School of Electrical and Information Engineering, Tianjin University, 300072 Tianjin, China
| | - Chang Liu
- Department of Emergency, Thoracic Clinical College, Tianjin Medical University, 300070 Tianjin, China
| | - Chao Zhang
- Department of Emergency, Tianjin Jinnan Hospital, 300350 Tianjin, China
| | - Yonghong Hou
- Department of Communication Engineering, School of Electrical and Information Engineering, Tianjin University, 300072 Tianjin, China
| | - Xiaomeng Zhang
- Department of Emergency, Tianjin Jinnan Hospital, 300350 Tianjin, China
| | - Jia Zhao
- Department of Cardiology, Tianjin Chest Hospital, 300222 Tianjin, China
| | - Guolei Sun
- Department of Emergency, Tianjin Jinnan Hospital, 300350 Tianjin, China
| | - Jia Zhou
- Department of Cardiology, Tianjin Chest Hospital, 300222 Tianjin, China
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