Sex-Related Anemia Contributes to Disparities in Outcome of Patients Younger Than 60 Years with ST-Elevation Myocardial Infarction

Abstract

Background: Younger women with ST-segment elevation myocardial infarction (STEMI) have a worse outcome than their age-matched male peers. Our aim was to assess whether there are sex-based differences in anemia on admission, and if they are associated with the outcome of patients with STEMI younger than 60 years undergoing primary percutaneous coronary intervention (PCI). Materials and Methods: Data of 2095 STEMI patients, 804 of whom were younger than 60 years, were analyzed. Data were analyzed using descriptive statistics. All-cause 30-day and 2-year mortality were documented. Results: Women had a higher prevalence of anemia compared with men on admission (34.4% in women vs. 20.0% in men; p < 0.0001). The 30-day mortality was similar in both groups (5.5% in women vs. 3.3% in men; p = 0.17). Anemia on admission, age, cardiogenic shock, and diabetes predicted higher 30-day mortality. Two-year mortality was higher in women (9.8% in women vs. 4.8% in men; p = 0.023). Anemia on admission, age, cardiogenic shock, and diabetes were identified as independent predictors of 2-year mortality. Sex was not associated with 30-day or 2-year mortality. Conclusions: We found sex-based differences in anemia on admission in STEMI patients younger than 60 years. Anemia, but not sex, was linked to 30-day and 2-year mortality. Anemia on admission in women younger than 60 years may help to explain the increased 2-year sex-related mortality in younger STEMI patients undergoing primary PCI.