Background Impact of gender on heart remodeling after acute coronary syndrome (ACS) and consequently on development of heart failure (HF) remains to be elucidated. Methods CORALYS is a multicenter, retrospective, observational registry enrolling consecutive patients admitted for ACS and treated with percutaneous coronary intervention. HF hospitalization was the primary endpoint while all-cause mortality and the composite endpoint of incidence of first HF hospitalization and cardiovascular mortality were the secondary ones. Results Among 14,699 patients enrolled in CORALYS registry, 4578 (31%) were women and 10,121 (69%) males. Women were older, had more frequently hypertension and diabetes and less frequently smoking habit. History of myocardial infarction (MI), STEMI at admission and multivessel disease were less common in women. After median follow up of 2.9 ± 1.8 years, women had higher incidence of primary and secondary endpoints and female sex was an independent predictor of HF hospitalization (HR 1.26;1.05–1.50; p = 0.011) and cardiovascular death/HF hospitalization (HR 1.18;1.02–1.37; p = 0.022). At multivariable analysis women and men share as predictors of HF diabetes, history of cancer, chronic kidney disease, atrial fibrillation, complete revascularization and left ventricular ejection fraction. Chronic obstructive pulmonary disease (HR 2.34;1.70–3.22, p < 0.001) and diuretics treatment (HR 1.61;1.27–2.04, p < 0.001) were predictor of HF in men, while history of previous MI (HR 1.46;1.08–1.97, p = 0.015) and treatment with inhibitors of renin-angiotensin system (HR 0.69;0,49–0.96 all 95% CI, p = 0.030) in women. Conclusions Women are at increased risk of HF after ACS and gender seems to be an outcome-modifier of the relationship between a variable and primary outcome.

Gender differences in the development of heart failure after acute coronary syndrome. insight from the CORALYS registry / Elia, Edoardo; Bruno, Francesco; Crimi, Gabriele; Wańha, Wojciech; Leonardi, Sergio; Mauro, Mattia; Raposeiras Roubin, Sergio; Fabris, Enrico; Giannino, Giuseppe; Mancone, Massimo; Severino, Paolo; Truffa, Alessandra; De Filippo, Ovidio; Huczek, Zenon; Mazurek, Maciej; Gaibazzi, Nicola; Ielasi, Alfonso; Cortese, Bernardo; Borin, Andrea; J Núñez-Gil, Iván; Marengo, Giorgio; Melis, Daniele; Ugo, Fabrizio; Bianco, Matteo; Barbieri, Lucia; Marchini, Federico; Desperak, Piotr; Morici, Nuccia; Scaglione, Marco; Gąsior, Mariusz; Gallone, Guglielmo; Lopiano, Clara; Stefanini, Giulio; Campo, Gianluca; Wojakowski, Wojciech; Abu-Assi, Emad; Sinagra, Gianfranco; Maria de Ferrari, Gaetano; Porto, Italo; D'Ascenzo, Fabrizio. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 1874-1754. - 397:(2024). [10.1016/j.ijcard.2023.131622]

Gender differences in the development of heart failure after acute coronary syndrome. insight from the CORALYS registry

Massimo Mancone;Paolo Severino;
2024

Abstract

Background Impact of gender on heart remodeling after acute coronary syndrome (ACS) and consequently on development of heart failure (HF) remains to be elucidated. Methods CORALYS is a multicenter, retrospective, observational registry enrolling consecutive patients admitted for ACS and treated with percutaneous coronary intervention. HF hospitalization was the primary endpoint while all-cause mortality and the composite endpoint of incidence of first HF hospitalization and cardiovascular mortality were the secondary ones. Results Among 14,699 patients enrolled in CORALYS registry, 4578 (31%) were women and 10,121 (69%) males. Women were older, had more frequently hypertension and diabetes and less frequently smoking habit. History of myocardial infarction (MI), STEMI at admission and multivessel disease were less common in women. After median follow up of 2.9 ± 1.8 years, women had higher incidence of primary and secondary endpoints and female sex was an independent predictor of HF hospitalization (HR 1.26;1.05–1.50; p = 0.011) and cardiovascular death/HF hospitalization (HR 1.18;1.02–1.37; p = 0.022). At multivariable analysis women and men share as predictors of HF diabetes, history of cancer, chronic kidney disease, atrial fibrillation, complete revascularization and left ventricular ejection fraction. Chronic obstructive pulmonary disease (HR 2.34;1.70–3.22, p < 0.001) and diuretics treatment (HR 1.61;1.27–2.04, p < 0.001) were predictor of HF in men, while history of previous MI (HR 1.46;1.08–1.97, p = 0.015) and treatment with inhibitors of renin-angiotensin system (HR 0.69;0,49–0.96 all 95% CI, p = 0.030) in women. Conclusions Women are at increased risk of HF after ACS and gender seems to be an outcome-modifier of the relationship between a variable and primary outcome.
2024
acute coronary syndrome; sex; heart failure; gender; women
01 Pubblicazione su rivista::01a Articolo in rivista
Gender differences in the development of heart failure after acute coronary syndrome. insight from the CORALYS registry / Elia, Edoardo; Bruno, Francesco; Crimi, Gabriele; Wańha, Wojciech; Leonardi, Sergio; Mauro, Mattia; Raposeiras Roubin, Sergio; Fabris, Enrico; Giannino, Giuseppe; Mancone, Massimo; Severino, Paolo; Truffa, Alessandra; De Filippo, Ovidio; Huczek, Zenon; Mazurek, Maciej; Gaibazzi, Nicola; Ielasi, Alfonso; Cortese, Bernardo; Borin, Andrea; J Núñez-Gil, Iván; Marengo, Giorgio; Melis, Daniele; Ugo, Fabrizio; Bianco, Matteo; Barbieri, Lucia; Marchini, Federico; Desperak, Piotr; Morici, Nuccia; Scaglione, Marco; Gąsior, Mariusz; Gallone, Guglielmo; Lopiano, Clara; Stefanini, Giulio; Campo, Gianluca; Wojakowski, Wojciech; Abu-Assi, Emad; Sinagra, Gianfranco; Maria de Ferrari, Gaetano; Porto, Italo; D'Ascenzo, Fabrizio. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 1874-1754. - 397:(2024). [10.1016/j.ijcard.2023.131622]
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