title: Sex, adverse cardiac events, and infarct size in anterior myocardial infarction: an analysis of intracoronary abciximab and aspiration thrombectomy in patients with large anterior myocardial infarction (INFUSE-AMI).
abstract: BACKGROUND
  Women are more likely than men to experience adverse cardiac events after ST-elevation myocardial (STEMI). Whether differences in infarct size or reperfusion contribute to sex differences in outcomes is unknown.
  
  
  METHODS
  We compared baseline and procedural characteristics, angiographic and electrocardiographic indices of reperfusion, microvascular obstruction, infarct size, and clinical outcomes in 118 women and 334 men with anterior STEMI enrolled in the INFUSE-AMI randomized trial of intralesion abciximab and aspiration thrombectomy (NCT00976521). Infarct size was assessed by cardiac magnetic resonance imaging at 30 days, and clinical end points were adjudicated by an independent committee.
  
  
  RESULTS
  Women were older, were more commonly affected by hypertension and renal impairment, and had a 50.5-minute longer delay to reperfusion. There were no differences in infarct size, microvascular obstruction, or reperfusion success. At 30 days, major adverse cardiac events (MACE), defined as death, reinfarction, new-onset severe heart failure, or rehospitalization for heart failure, were more common in women (11.1% vs 5.4%, hazard ratio 2.09, 95% CI 1.03-4.27, P = .04). After multivariable adjustment, age, but not sex or time to reperfusion, was an independent predictor of MACE.
  
  
  CONCLUSIONS
  In the INFUSE-AMI randomized trial, women with anterior STEMI experienced a higher rate of MACE, attributable to older age. Despite longer delay from symptom onset to reperfusion therapy, there was no difference between women and men in infarct size or reperfusion success.
authors.affiliation: The Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Matthew I
authors.initials: MI
authors.lastname: Tomey
authors.affiliation: The Icahn School of Medicine at Mount Sinai, New York, NY; Cardiovascular Research Foundation, New York, NY. Electronic address: roxana.mehran@mountsinai.org.
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.affiliation: Cardiovascular Research Foundation, New York, NY; New York Methodist Hospital, Brooklyn, NY.
authors.forename: Sorin J
authors.initials: SJ
authors.lastname: Brener
authors.affiliation: Cardiovascular Research Foundation, New York, NY; Columbia University Medical Center, New York, NY.
authors.forename: Akiko
authors.initials: A
authors.lastname: Maehara
authors.affiliation: Charité Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Witzenbichler
authors.affiliation: Columbia University Medical Center, New York, NY.
authors.forename: José M
authors.initials: JM
authors.lastname: Dizon
authors.affiliation: Manchester Heart Centre, Manchester, United Kingdom.
authors.forename: Magdi
authors.initials: M
authors.lastname: El-Omar
authors.affiliation: Cardiovascular Research Foundation, New York, NY.
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.affiliation: Beth Israel Deaconess Medical Center-Harvard Medical School, Boston, MA.
authors.forename: C Michael
authors.initials: CM
authors.lastname: Gibson
authors.affiliation: Cardiovascular Research Foundation, New York, NY; Columbia University Medical Center, New York, NY.
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
mesh_terms: D000077284:Abciximab; D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D017023:Coronary Angiography; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D012008:Recurrence; D012737:Sex Factors; D017131:Thrombectomy; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab