{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Maznyczka AM"],"funding":["British Heart Foundation","Chief Scientist Office"],"pagination":["e000979"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC6519583"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["6(1)"],"pubmed_abstract":["<h4>Objectives</h4>We aimed to assess for sex differences in invasive parameters of acute microvascular reperfusion injury and infarct characteristics on cardiac MRI after ST-segment elevation myocardial infarction (STEMI).<h4>Methods</h4>Patients with STEMI undergoing emergency percutaneous coronary intervention (PCI) were prospectively enrolled. Index of microcirculatory resistance (IMR) and coronary flow reserve (CFR) were measured in the culprit artery post-PCI. Contrast-enhanced MRI was used to assess infarct characteristics, microvascular obstruction and myocardial haemorrhage, 2 days and 6 months post-STEMI. Prespecified outcomes were as follows: (i) all-cause death/first heart failure hospitalisation and (ii) cardiac death/non-fatal myocardial infarction/urgent coronary revascularisation (major adverse cardiovascular event, MACE) during 5- year median follow-up.<h4>Results</h4>In 324 patients with STEMI (87 women, mean age: 61 ± 12.19 years; 237 men, mean age: 59 ± 11.17 years), women had anterior STEMI less often, fewer prescriptions of beta-blockers at discharge and higher baseline N-terminal pro-B-type natriuretic peptide levels (all p < 0.05). Following emergency PCI, fewer women than men had Thrombolysis in Myocardial Infarction (TIMI) myocardial perfusion grades ≤ 1 (20% vs 32%, p = 0.027) and women had lower corrected TIMI frame counts (12.94 vs 17.65, p = 0.003). However, IMR, CFR, microvascular obstruction, myocardial haemorrhage, infarct size, myocardial salvage index, left ventricular remodelling and ejection fraction did not differ significantly between sexes. Female sex was not associated with MACE or all-cause death/first heart failure hospitalisation.<h4>Conclusion</h4>There were no sex differences in microvascular pathology in patients with acute STEMI. Women had less anterior infarcts than men, and beta-blocker therapy at discharge was prescribed less often in women.<h4>Trial registration number</h4>NCT02072850."],"journal":["Open heart"],"pubmed_title":["Sex-based associations with microvascular injury and outcomes after ST-segment elevation myocardial infarction."],"pmcid":["PMC6519583"],"funding_grant_id":["FS/16/74/32573","FS/12/62/29889","PG/11/2/28474","SCD/01"],"pubmed_authors":["Ford I","Hood S","Lindsay M","Carberry J","Oldroyd KG","Eteiba H","Berry C","Davie A","Petrie MC","Sattar N","Mangion K","Carrick D","Watkins S","McEntegart M","Maznyczka AM","Mahrous A","Welsh P"],"additional_accession":[]},"is_claimable":false,"name":"Sex-based associations with microvascular injury and outcomes after ST-segment elevation myocardial infarction.","description":"<h4>Objectives</h4>We aimed to assess for sex differences in invasive parameters of acute microvascular reperfusion injury and infarct characteristics on cardiac MRI after ST-segment elevation myocardial infarction (STEMI).<h4>Methods</h4>Patients with STEMI undergoing emergency percutaneous coronary intervention (PCI) were prospectively enrolled. Index of microcirculatory resistance (IMR) and coronary flow reserve (CFR) were measured in the culprit artery post-PCI. Contrast-enhanced MRI was used to assess infarct characteristics, microvascular obstruction and myocardial haemorrhage, 2 days and 6 months post-STEMI. Prespecified outcomes were as follows: (i) all-cause death/first heart failure hospitalisation and (ii) cardiac death/non-fatal myocardial infarction/urgent coronary revascularisation (major adverse cardiovascular event, MACE) during 5- year median follow-up.<h4>Results</h4>In 324 patients with STEMI (87 women, mean age: 61 ± 12.19 years; 237 men, mean age: 59 ± 11.17 years), women had anterior STEMI less often, fewer prescriptions of beta-blockers at discharge and higher baseline N-terminal pro-B-type natriuretic peptide levels (all p < 0.05). Following emergency PCI, fewer women than men had Thrombolysis in Myocardial Infarction (TIMI) myocardial perfusion grades ≤ 1 (20% vs 32%, p = 0.027) and women had lower corrected TIMI frame counts (12.94 vs 17.65, p = 0.003). However, IMR, CFR, microvascular obstruction, myocardial haemorrhage, infarct size, myocardial salvage index, left ventricular remodelling and ejection fraction did not differ significantly between sexes. Female sex was not associated with MACE or all-cause death/first heart failure hospitalisation.<h4>Conclusion</h4>There were no sex differences in microvascular pathology in patients with acute STEMI. Women had less anterior infarcts than men, and beta-blocker therapy at discharge was prescribed less often in women.<h4>Trial registration number</h4>NCT02072850.","dates":{"release":"2019-01-01T00:00:00Z","publication":"2019","modification":"2026-06-17T06:15:01.477Z","creation":"2026-06-17T03:07:56.862Z"},"accession":"S-EPMC6519583","cross_references":{"pubmed":["31168381"],"doi":["10.1136/openhrt-2018-000979"]}}