고령의 급성 심근경색증 환자에서 성별에 따른 영향
Impact of Gender Differences in Elderly Patients with Acute Myocardial Infarction
설수영, 정명호, 이승헌, 손석준, 조재영, 김민철, 심두선, 홍영준, 박형욱, 김주한, 안영근, 조정관, 박종춘,
소속 상세정보
설수영 ( Seol Soo-Young )
전남대학교병원 심장센터
정명호 ( Jeong Myung-Ho )
전남대학교병원 심장센터
이승헌 ( Lee Seung-Hun )
전남대학교병원 심장센터
손석준 ( Sohn Seok-Joon )
전남대학교 의과대학 예방의학교실
조재영 ( Cho Jae-Yeong )
전남대학교병원 심장센터
김민철 ( Kim Min-Chul )
전남대학교병원 심장센터
심두선 ( Sim Doo-Sun )
전남대학교병원 심장센터
홍영준 ( Hong Young-Joon )
전남대학교병원 심장센터
박형욱 ( Park Hyung-Wook )
전남대학교병원 심장센터
김주한 ( Kim Ju-Han )
전남대학교병원 심장센터
안영근 ( Ahn Young-Keun )
전남대학교병원 심장센터
조정관 ( Cho Jeong-Gwan )
전남대학교병원 심장센터
박종춘 ( Park Jong-Chun )
전남대학교병원 심장센터
Abstract
Background/Aims: It is well known that gender differences are associated with clinical outcomes in patients with acute myocardial infarction (AMI). However, it is not clear whether gender differences affect the prognosis of elderly patients with AMI.
Methods: We analyzed the incidence of in-hospital complications and mortality in the Korea Acute Myocardial Infarction Registry-National Institutes of Health from November 2011 to June 2015. This study included elderly patients (≥ 75 years) diagnosed with AMI.
Results: A total of 2,953 patients were eligible for this study. Among them, 1,529 (51.8%) patients were female, and the mean age of the female group was older than that of the male group (80.7 ± 4.4 vs. 79.6 ± 4.0 years, respectively, p < 0.001). Elderly females utilized emergency medical services less frequently compared with elderly males (11.5 vs. 15.4%, respectively, p < 0.001). Elderly female AMI patients had a similar rate of in-hospital mortality compared with elderly males (7.1 vs. 8.4%, respectively, p = 0.196). The rate of major cardiac adverse events (MACEs) was lower in elderly females than males during a 12-month follow-up (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.00-1.41, p = 0.045). According to multivariate analysis, the male gender is an independent factor for predicting 1-year MACEs (HR 1.37, 95% CI 1.14-1.65, p < 0.001).
Conclusions: No significant differences in peri-procedural complications or in-hospital mortality were observed between male and female elderly patients with AMI. However, elderly female patients had a more favorable prognosis than male patients during a 1-year clinical follow-up.
키워드
yocardial infarction; Prognosis; Gender
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