title: Gender differences in risk factors and clinical outcomes in young patients with acute myocardial infarction.
abstract: There are limited data on the influence of gender on risk factors and clinical outcomes in young patients with acute myocardial infarction (AMI).
  
  
  
  This prospective study stratified outcomes according to gender in patients of age ≤50 years with a diagnosis of AMI, and who were enrolled in the nationwide registry of the Korea Working Group of Myocardial Infarction. The end point was the incidence of major adverse cardiovascular events (MACEs) defined as the composite of cardiac death, recurrent myocardial infarction (MI), and repeat revascularisation at 30 days and 1 year after admission.
  
  
  
  The registry enrolled 30 001 patients with AMI, of whom 5200 met the study inclusion criteria; 4805 patients were male and 395 were female. Current smoking was significantly higher in men, while hypertension and diabetes mellitus were significantly more common in women. Women underwent less coronary revascularisation, and were less likely to be on optimal medical therapy compared with men despite having a higher Killip class at presentation and higher risk angiographic findings. Although women had higher rates of MACEs (3.8% vs 1.8%, p=0.018 at 30 days and 7.8% vs 4.7%, p=0.004 at 1-year follow-up) compared with men, female gender was not an independent predictor of MACEs after adjusting for propensity score.
  
  
  
  There were significant gender differences in the risk factors for coronary artery disease and the short-term and long-term clinical outcomes of young patients with AMI. Continued preventive strategies should be focused on gender-different risk factor reduction in these young patients.
authors.affiliation: Department of Cardiology, Kosin University School of Medicine, Busan, South Korea.
authors.forename: Kyoung Im
authors.initials: KI
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
authors.forename: Eun-Seok
authors.identifier: 0000-0002-9169-6968
authors.initials: ES
authors.lastname: Shin
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
authors.forename: Soe Hee
authors.initials: SH
authors.lastname: Ann
authors.affiliation: East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, UK.
authors.forename: Scot
authors.initials: S
authors.lastname: Garg
authors.affiliation: Division of Cardiology, Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, South Korea.
authors.forename: Ae-Young
authors.initials: AY
authors.lastname: Her
authors.affiliation: Department of Cardiology, Pusan National University School of Medicine, Yangsan, South Korea.
authors.forename: Jeong Su
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Division of Biostatistics, Research Institute of Convergence for Biomedical Science and Technology, Pusan National University School of Medicine, Yangsan, South Korea.
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Han
authors.affiliation: The Heart Center of Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome
keywords: CHD/CORONORARY HEART; Clinical epidemiology; GENDER; Outcome Research Evaluation