ISSN: 2451-0629
Archives of Medical Science - Atherosclerotic Diseases
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Official journal of the International Lipid Expert Panel (ILEP)
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1/2021
vol. 6
 
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abstract:
Clinical research

The effect of cardiac geometry variation according to sex and race on outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention

Edward T. Ha
1
,
Marc Cohen
2, 3
,
Theodore J. Gaeta
4, 5
,
Manish A. Parikh
1, 5
,
Stephen J. Peterson
1, 5
,
Wilbert S. Aronow
6, 7

1.
Department of Internal Medicine, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
2.
Department of Cardiology, Newark Beth Israel Medical Center, Newark, NJ, USA
3.
Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA
4.
Department of Emergency Medicine, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
5.
Department of Medicine, Weill Cornell Medical College, New York, NY, USA
6.
Department of Cardiology, Westchester Medical Center, Valhalla, NY, USA
7.
Department of Medicine, New York Medical College, Valhalla, NY, USA
Arch Med Sci Atheroscler Dis 2021; 6: e152–e159
Online publish date: 2021/07/19
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Introduction
The prevalence and long-term consequences of differences in baseline cardiac geometry (as a result of hypertension) in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) are ill-defined. The primary purpose of this study was to clarify whether there were differences among sexual and racial groups in echocardiographic findings reflecting cardiac geometry and adaptation in patients undergoing PCI for ACS and whether this could explain the differences in outcomes seen between these groups.

Material and methods
We analyzed 1-year follow-up data from a single institution, a retrospective, observational study that enrolled 1,153 patients who presented with ACS and were treated with PCI, for whom echocardiographic data were available.

Results
Normal, concentric hypertrophy, and eccentric hypertrophy in males vs. females were observed as follows: 29% vs. 19% (p = 0.001), 25% vs. 31% (p = 0.02), and 8% vs. 14% (p = 0.004), respectively. The primary endpoint of all-cause death (n = 89, 7.7%) occurred in 48 (10.5%) females and in 41 (8.2%) males, p = 0.03. Major adverse cardiac events and bleeding (MACE-B – all-cause death, non-fatal myocardial infarction, stroke or hospitalization for bleeding) was higher among women than men (21.6% vs. 13.5%, p = 0.0002). Males with eccentric hypertrophy (EH) had similar MACE-B outcomes as females with EH 1-year post-PCI (29% vs. 32%, respectively, p = 0.77).

Conclusions
Females undergoing PCI for ACS are at higher risk for worse outcomes because they are more likely to express the eccentric hypertrophy phenotype; however, it did not account for the difference in adverse outcomes observed between sexes.

keywords:

heart failure, heart attack, sex, left ventricular hypertrophy, major adverse cardiac events, race, differences, myocardial infarction

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