title: Age and sex differences in perioperative myocardial infarction after cardiac surgery.
abstract: We investigate age and sex differences in acute myocardial infarction (AMI) after cardiac surgery in a prospective study of 2038 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass. An age of ≥ 70 years implied changes in the type of AMI from the ST-segment elevation myocardial infarction (STEMI) to non-ST-segment elevation myocardial infarction (non-STEMI). Men were more likely than women to suffer from AMI after cardiac surgery (11.8% vs. 5.6%), as a result of the higher frequency of STEMI (6% of men vs. 1.8% of women; P < 0.001) in both age groups. A troponin-I (Tn-I) peak was significantly higher in patients ≥ 70 years old. In-hospital mortality was higher in patients ≥ 70 (7.3%) than in those < 70 years old (3.3%), because of the increased mortality observed in men with non-AMI (2.1% vs. 6.3%) and women with STEMI (0% vs. 28.6%) and non-STEMI (0% vs. 36.8%, P < 0.05). Old age was associated with a higher frequency of non-STEMI, Tn-I peak, mortality and length of stay in the intensive care unit (ICU). Regardless of age, men more often suffer from AMI (particularly STEMI). AMI in women had a notable impact on excess mortality and ICU stay observed in patients ≥ 70 years of age. Clinical and Tn-I peak differences are expected in relation to age and gender after AMI post-cardiac surgery.
authors.affiliation: Department of Physiological Sciences II, School of Medicine, University of Barcelona, IDIBELL, L'Hospitalet, Barcelona, Spain. cjavierre@ub.edu
authors.forename: Casimiro
authors.initials: C
authors.lastname: Javierre
authors.forename: Antoni
authors.initials: A
authors.lastname: Ricart
authors.forename: Rafael
authors.initials: R
authors.lastname: Manez
authors.forename: Elisabet
authors.initials: E
authors.lastname: Farrero
authors.forename: Maria L
authors.initials: ML
authors.lastname: Carrio
authors.forename: David
authors.initials: D
authors.lastname: Rodriguez-Castro
authors.forename: Herminia
authors.initials: H
authors.lastname: Torrado
authors.forename: Josep L
authors.initials: JL
authors.lastname: Ventura
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology* / Q000401:mortality; D059035:Perioperative Period; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain; D013997:Time Factors; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I