Age and sex differences in perioperative myocardial infarction after cardiac surgery

• Published in: Interactive cardiovascular and thoracic surgery Vol. 15; no. 1; pp. 28 - 32
• Main Authors: Javierre, Casimiro, Ricart, Antoni, Manez, Rafael, Farrero, Elisabet, Carrio, Maria L., Rodriguez-Castro, David, Torrado, Herminia, Ventura, Josep L.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.07.2012
• Subjects: Age Factors; Aged; Analysis of Variance; Biomarkers - blood; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Cardiopulmonary Bypass - adverse effects; Chi-Square Distribution; Female; Hospital Mortality; Humans; Incidence; Intensive Care Units; Length of Stay; Male; Myocardial Infarction - blood; Myocardial Infarction - etiology; Myocardial Infarction - mortality; Original; Perioperative Period; Prospective Studies; Risk Assessment; Risk Factors; Sex Factors; Spain; Time Factors; Troponin I - blood; Spain; Sex differences; Cardiac surgery; Acute myocardial infarction; Outcome; STEMI/non-STEMI; Age differences
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivr130

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.