Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients – data from the CHILL-MI, MITOCARE and SOCCER trials
Abstract Background Infarct evolution rate and response to acute reperfusion therapy may differ between patients, which is important to consider for accurate management and treatment of patients with ST-elevation myocardial infarction (STEMI). The aim of this study was therefore to investigate the a...
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doaj-a0b77ed4f7864b2c8ba605cb462026c82020-11-25T03:38:45ZengBMCBMC Cardiovascular Disorders1471-22612019-07-0119111010.1186/s12872-019-1139-7Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients – data from the CHILL-MI, MITOCARE and SOCCER trialsDavid Nordlund0Henrik Engblom1Jean-Louis Bonnet2Henrik Steen Hansen3Dan Atar4David Erlinge5Ulf Ekelund6Einar Heiberg7Marcus Carlsson8Håkan Arheden9Department of Clinical Physiology, Clinical Sciences, Lund UniversityDepartment of Clinical Physiology, Clinical Sciences, Lund UniversityAssistance Publique Hôpitaux de Marseille, Hôpital La TimoneDepartment of Cardiology B, Odense University HospitalDepartment of Cardiology B, Oslo University Hospital Ullevål, and Faculty of Medicine, University of OsloDepartment of Cardiology, Clinical Sciences, Lund UniversityDepartment of Emergency Medicine, Clinical Sciences, Lund UniversityDepartment of Clinical Physiology, Clinical Sciences, Lund UniversityDepartment of Clinical Physiology, Clinical Sciences, Lund UniversityDepartment of Clinical Physiology, Clinical Sciences, Lund UniversityAbstract Background Infarct evolution rate and response to acute reperfusion therapy may differ between patients, which is important to consider for accurate management and treatment of patients with ST-elevation myocardial infarction (STEMI). The aim of this study was therefore to investigate the association of infarct size and myocardial salvage with gender, smoking status, presence of diabetes or history of hypertension in a cohort of STEMI-patients. Methods Patients (n = 301) with first-time STEMI from the three recent multi-center trials (CHILL-MI, MITOCARE and SOCCER) underwent cardiac magnetic resonance (CMR) imaging to determine myocardium at risk (MaR) and infarct size (IS). Myocardial salvage index (MSI) was calculated as MSI = 1-IS/MaR. Pain to balloon time, culprit vessel, trial treatments, age, TIMI grade flow and collateral flow by Rentrop grading were included as explanatory variables in the statistical model. Results Women (n = 66) had significantly smaller MaR (mean difference: 5.0 ± 1.5% of left ventricle (LV), p < 0.01), smaller IS (mean difference: 5.1 ± 1.4% of LV, p = 0.03), and larger MSI (mean difference: 9.6 ± 2.8% of LV, p < 0.01) compared to men (n = 238). These differences remained significant when adjusting for other explanatory variables. There were no significant effects on MaR, IS or MSI for diabetes, hypertension or smoking. Conclusions Female gender is associated with higher myocardial salvage and smaller infarct size suggesting a pathophysiological difference in infarct evolution between men and women.http://link.springer.com/article/10.1186/s12872-019-1139-7Area at riskGenderSexDiabetesHypertension |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David Nordlund Henrik Engblom Jean-Louis Bonnet Henrik Steen Hansen Dan Atar David Erlinge Ulf Ekelund Einar Heiberg Marcus Carlsson Håkan Arheden |
spellingShingle |
David Nordlund Henrik Engblom Jean-Louis Bonnet Henrik Steen Hansen Dan Atar David Erlinge Ulf Ekelund Einar Heiberg Marcus Carlsson Håkan Arheden Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients – data from the CHILL-MI, MITOCARE and SOCCER trials BMC Cardiovascular Disorders Area at risk Gender Sex Diabetes Hypertension |
author_facet |
David Nordlund Henrik Engblom Jean-Louis Bonnet Henrik Steen Hansen Dan Atar David Erlinge Ulf Ekelund Einar Heiberg Marcus Carlsson Håkan Arheden |
author_sort |
David Nordlund |
title |
Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients – data from the CHILL-MI, MITOCARE and SOCCER trials |
title_short |
Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients – data from the CHILL-MI, MITOCARE and SOCCER trials |
title_full |
Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients – data from the CHILL-MI, MITOCARE and SOCCER trials |
title_fullStr |
Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients – data from the CHILL-MI, MITOCARE and SOCCER trials |
title_full_unstemmed |
Gender but not diabetes, hypertension or smoking affects infarct evolution in ST-elevation myocardial infarction patients – data from the CHILL-MI, MITOCARE and SOCCER trials |
title_sort |
gender but not diabetes, hypertension or smoking affects infarct evolution in st-elevation myocardial infarction patients – data from the chill-mi, mitocare and soccer trials |
publisher |
BMC |
series |
BMC Cardiovascular Disorders |
issn |
1471-2261 |
publishDate |
2019-07-01 |
description |
Abstract Background Infarct evolution rate and response to acute reperfusion therapy may differ between patients, which is important to consider for accurate management and treatment of patients with ST-elevation myocardial infarction (STEMI). The aim of this study was therefore to investigate the association of infarct size and myocardial salvage with gender, smoking status, presence of diabetes or history of hypertension in a cohort of STEMI-patients. Methods Patients (n = 301) with first-time STEMI from the three recent multi-center trials (CHILL-MI, MITOCARE and SOCCER) underwent cardiac magnetic resonance (CMR) imaging to determine myocardium at risk (MaR) and infarct size (IS). Myocardial salvage index (MSI) was calculated as MSI = 1-IS/MaR. Pain to balloon time, culprit vessel, trial treatments, age, TIMI grade flow and collateral flow by Rentrop grading were included as explanatory variables in the statistical model. Results Women (n = 66) had significantly smaller MaR (mean difference: 5.0 ± 1.5% of left ventricle (LV), p < 0.01), smaller IS (mean difference: 5.1 ± 1.4% of LV, p = 0.03), and larger MSI (mean difference: 9.6 ± 2.8% of LV, p < 0.01) compared to men (n = 238). These differences remained significant when adjusting for other explanatory variables. There were no significant effects on MaR, IS or MSI for diabetes, hypertension or smoking. Conclusions Female gender is associated with higher myocardial salvage and smaller infarct size suggesting a pathophysiological difference in infarct evolution between men and women. |
topic |
Area at risk Gender Sex Diabetes Hypertension |
url |
http://link.springer.com/article/10.1186/s12872-019-1139-7 |
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