Kanic Vojko, Kompara Gregor, Suran David
Division of Internal Medicine, Department of Cardiology and Angiology, University Medical Center Maribor, Maribor, Slovenia.
Front Cardiovasc Med. 2023 Feb 23;10:1108710. doi: 10.3389/fcvm.2023.1108710. eCollection 2023.
Data on the possible sex-specific effects of anemia on clinical outcome in patients with myocardial infarction are extremely sparse, conflicting, and inconclusive. We investigated the possible sex-specific effects of anemia on outcome in patients with myocardial infarction (MI) who underwent percutaneous coronary intervention (PCI).
Data from 8,318 patients, who were divided into four groups: men and women with and without anemia on admission, were analyzed. The association between anemia and sex and 30-day and long-term mortality was assessed. The median follow-up time was 7 years (25th, 75th percentile: 4, 11).
Non-anemic men had the lowest 30-day and long-term observed mortality (4.3, 18.7%), followed by non-anemic women (7.0, 25.3%; p < 0.0001, p < 0.0001). Anemic men and women had similar mortality rates (12.8, 46.2%) and (13.4, 45.6%; p = 0.70, p = 0.80), respectively. The anemia/sex groups were independently associated with 30-day and long-term mortality (p = 0.033 and p < 0.0001, respectively). Compared to non-anemic men, non-anemic and anemic women had a similar risk of death at 30 days, but anemic men had a 50% higher risk of death (OR 1.12; 95% CI 0.83-1.52; p = 0.45, OR 1.30; 95% CI 0.94-1.79; p = 0.11, OR 1.50; 95% CI 1.13-1.98; p = 0.004, respectively). In the long term, anemic men had a 46% higher, non-anemic women 15% lower, and anemic women a similar long-term mortality risk to non-anemic men (HR 1.46; 95% CI 1.31-1.63; p < 0.0001, HR 0.85; 95% CI 0.76-0.96; p = 0.011, and HR 1.06; 95% CI 0.93-1.21; p = 0.37, respectively).
Our result suggests that the influence of anemia in patients with MI is different in men and women, with anemia seemingly much more harmful in male than in female patients with MI.
关于贫血对心肌梗死患者临床结局可能存在的性别特异性影响的数据极为稀少、相互矛盾且尚无定论。我们调查了贫血对接受经皮冠状动脉介入治疗（PCI）的心肌梗死（MI）患者结局可能存在的性别特异性影响。
分析了8318例患者的数据，这些患者被分为四组：入院时有无贫血的男性和女性。评估贫血与性别以及30天和长期死亡率之间的关联。中位随访时间为7年（第25、75百分位数：4、11）。
非贫血男性的30天和长期观察到的死亡率最低（4.3%，18.7%），其次是非贫血女性（7.0%，25.3%；p<0.0001，p<0.0001）。贫血男性和女性的死亡率相似（分别为12.8%，46.2%和13.4%，45.6%；p=0.70，p=0.80）。贫血/性别组与30天和长期死亡率独立相关（分别为p=0.033和p<0.0001）。与非贫血男性相比，非贫血和贫血女性在30天时死亡风险相似，但贫血男性死亡风险高50%（OR 1.12；95%CI 0.83 - 1.52；p = 0.45，OR 1.30；95%CI 0.94 - 1.79；p = 0.11，OR 1.50；95%CI 1.13 - 1.98；p = 0.004）。从长期来看，贫血男性的长期死亡风险高46%，非贫血女性低15%，贫血女性与非贫血男性的长期死亡风险相似（HR 1.46；95%CI 1.31 - 1.63；p<0.0001，HR 0.85；95%CI 0.76 - 0.96；p = 0.011，HR 1.06；95%CI 0.93 - 1.21；p = 0.37）。
我们的结果表明，贫血对MI患者的影响在男性和女性中有所不同，贫血对男性MI患者的危害似乎比女性更大。
