Sex-related differences in outcomes after surgical treatment for post-infarction mechanical complications

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Abstract Background Despite several registries explored sex differences in patients underwent acute myocardial infarction (AMI), data concerning mechanical complications following AMI are still to be described. Aims We aimed to investigate sex-related differences in the outcomes following surgical treatment for post-acute myocardial infarction mechanical complications. Methods and Results Using the CAUTION study database, we examined sex differences patients with post-infarction mechanical complications undergone surgical treatment. The primary outcome was in-hospital mortality. Secondary outcomes included long-term mortality, between sex differences in characteristics, and predictors of in-hospital and overall mortality for either sex group. From a total of 805 patients, women (34.9%) were older [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.02–1.06, P < .001], were more likely to have diabetes mellitus (OR 1.59, 95% CI 1.05–2.43, P = .031), more often presented with anterior myocardial infarction (OR 0.50, 95% CI 0.33–0.74, P = .001) and had higher in-hospital mortality (OR 1.75, 95% CI 1.02–3.02, P = .044) than men. Overall, the median follow-up period was 3.6 years. Survival rates at 1, 5, and 10 years were 50.2%, 45.7%, and 39.4% for women, and 59.1%, 52.7%, and 44.7% for male patients, respectively (log-rank P = .035). Long-term survival of hospital survivors stratified by gender at 1-, 5-, and 10-year survival was 84.5%, 76.9%, and 66.4% for women, and 85.8%, 76.7%, and 65.0% for men, respectively (log-rank P = .901). Conclusions Women have higher in-hospital mortality rate and worse overall survival than men after surgical treatment for post-infarction mechanical complications.

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