Abstract
Introduction: Recent studies reported a decrease in the incidence of acute myocardial infarction. This favorable evolution does not extend to young women. The interaction between gender, risk factors and myocardial infarction incidence remains controversial. Objective: To compare the evolution of the age pyramid of patients with ST-elevation myocardial infarction (STEMI) according to gender. Methods: Data from patients with STEMI managed in pre-hospital settings prospectively collected in the greater Paris area. Evolution of patient demographics and risk factors was investigated. Results: 28,249 patients with STEMI were included in the registry between 2002 and 2014, 21,883 (77%) males and 6366 (23%) females. The sex ratio did not significantly vary over the study period (p = 0.4). Median patient age was 60.1 years (51.1–73.0) and was significantly different between males and females, respectively 57.9 (50.0–68.3) vs. 72.9 years (58.3–82.2) (p = 0.0004). The median age of males significantly (p = 0.0044) increased from 57.6 (50.1–70.0) in 2002 to 58.1 years (50.5–67.8) in 2014. The median age of females significantly (p = 0.0006) decreased from 73.7 (57.9–81.8) to 69.6 years (57.0–82.4). The median gap between the age of men and women significantly (p = 0.0002) decreased, from 16.1 to 11.5 years. Prevalence of risk factors was unchanged or decreased except for hypertension which significantly increased in males. The rate of STEMI without reported risk factors increased in both males and females. Conclusion: The age of STEMI onset significantly decreased in females, whereas it significantly increased in males. The prevalence of risk factors decreased in males, whereas no significant variation was found in females.
Highlights
Recent studies reported a decrease in the incidence of acute myocardial infarction
Many studies have reported a decrease in the incidence of ST-segment elevation acute myocardial infarction (STEMI) in recent years in Europe and in the United States [1,2]
It seemed to us that the analysis of the age pyramid in a registry of acute myocardial infarction that had been running since 2002 would make it possible to study the evolution of the age of onset of acute myocardial infarction
Summary
Recent studies reported a decrease in the incidence of acute myocardial infarction This favorable evolution does not extend to young women. Many studies have reported a decrease in the incidence of ST-segment elevation acute myocardial infarction (STEMI) in recent years in Europe and in the United States [1,2]. This finding contrasts with the overall increase in the prevalence of cardiovascular risk factors, diabetes, cholesterol and obesity, and even smoking [3–6]. This could be true in France where the prevalence of smoking has increased dramatically in women over the last decade, having even doubled in those aged 55–64 [8] This is important, because smoking is the main determining factor of cardiovascular risk in many young people. It seemed to us that the analysis of the age pyramid in a registry of acute myocardial infarction that had been running since 2002 would make it possible to study the evolution of the age of onset of acute myocardial infarction
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