Turkish Journal of Geriatrics 2018 , Vol 21, Issue 3
SEX-RELATED DIFFERENCES ON MORTALITY IN PATIENTS AGED 80 YEARS OR OLDER WITH ACUTE MYOCARDIAL INFARCTION: THERE IS STILL A GAP
Kudret KESKİN1, Gökhan ÇETİNKAL1, Süleyman Sezai YILDIZ1, Serhat SIĞIRCI1, Şükrü ÇETİN1, Ahmet GÜRDAL1, Betül BALABAN KOCAŞ1, Kadriye ORTA KILIÇKESMEZ1
1ÅžiÅŸli Hamidiye Etfal Education and Research Hospital, Department of Cardiology, Cardiologist ÅžiÅŸli 34377 Ä°stanbul, Turkey DOI : 10.31086/tjgeri.2018344040 Introduction: Sex-related differences on cardiovascular mortality in patients with acute coronary syndrome have been debated for decades. Although the gap between the two sexes has begun to close, women still have higher all-cause mortality. However, there is little data with respect to elderly women, particularly for those over 80 years. Therefore, we sought to determine all-cause mortality of elderly women with acute myocardial infarction and to compare it to men.

Materials and Method: This retrospective study evaluated patients 80 years or older who were admitted to the cardiology clinic due to acute myocardial infarction between May 2015 and November 2017. The primary outcomes of the study were in-hospital, 30-day, and longterm all-cause mortality.

Results: Two hundred twenty patients (126 women and 94 men) were included in the final analysis. Median follow-up was eight months. Long-term all-cause mortality of women was significantly higher compared to men [n=52 (41.3%) vs. n=26 (27.7%), respectively; p=0.03]. There was no significant sex difference for both in-hospital and 30-day mortality, although women had more events. Kaplan-Meier analysis revealed lower cumulative survival for women (log-rank: p=0.02), and Cox regression analysis found that female sex was as an independent risk factor for mortality [hazard ratio=1.7 (95% confidence interval=1.06-2.72); p=0.02].

Conclusion: Sex-related differences on mortality continue to be a critical issue, even for elderly patients with acute myocardial infarction. Since women have significantly higher longterm all-cause mortality, they should strictly be treated according to the guidelines and every effort should be made for risk reduction with close follow-up. Keywords : Acute coronary syndrome; Coronary artery disease; Aged; Aged, 80 and over; Gender identity