Sex Differences in Systolic Heart Failure in Patients with Acute ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Intervention

Abstract

Aims: Sex differences refer to the biological and physiological variations in the cardiovascular system that arise from distinct gene expressions associated with sex chromosomes. Notable and well-documented sex differences in ST-elevation myocardial infarction (STEMI) indicate that women tend to be elderly and present with a more significant number of comorbidities in comparison to men. The aim is to investigate sex-specific differences in systolic heart failure (SHF) among patients with acute STEMI who are undergoing primary percutaneous coronary intervention (PCI). This study also included a follow-up period of three months to assess the occurrence of major adverse cardiovascular events (MACE) and to conduct a conventional echocardiographic evaluation. Study Design: This investigation is a prospective cohort study. Place and Duration of Study: Department of Cardiology, Faculty of Medicine, Benha University, AlQalyubia, Egypt, between October 2023 and October 2024. Methods: We included 116 adult patients with SHF following STEMI undergoing primary PCI. The subjects were divided into two equal groups: male (58 cases) and female (58 cases). Results: Females exhibited significantly higher NT-proBNP levels and lower left ventricular ejection fraction (LVEF) than males (P<0.001, P=0.02, respectively). Readmission with acute heart failure (AHF) at three months was significantly increased in females compared to males (P => 0.001). Cardiovascular death and AHF at three months were significantly higher in females compared to males (P = 0.031). Females showed significantly higher MACE compared to males (P= 0.016). Conclusions: Female patients with SHF following STEMI who undergo primary PCI have a higher risk of cardiovascular mortality within the first three months compared to males. The observed difference in mortality suggests that female patients may require different clinical approaches and closer follow-up to improve outcomes.