Skip to main content
Journal cover image

Sex Differences in Clinical Characteristics and Outcomes After Myocardial Infarction With Low Ejection Fraction: Insights From PARADISE-MI.

Publication ,  Journal Article
Wang, X; Jering, KS; Cikes, M; Tokmakova, MP; Mehran, R; Han, Y; East, C; Mody, FV; Wang, Y; Lewis, EF; Claggett, B; McMurray, JJV ...
Published in: J Am Heart Assoc
September 5, 2023

Background Studies demonstrated sex differences in outcomes following acute myocardial infarction, with women more likely to develop heart failure (HF). Sacubitril/valsartan has been shown to reduce cardiovascular death and HF hospitalizations in patients with HF with reduced ejection fraction. Methods and Results A total of 5661 patients (1363 women [24%]) with acute myocardial infarction complicated by reduced left ventricular ejection fraction (≤40%), pulmonary congestion, or both and ≥1 of 8 risk-augmenting factors were randomized to receive sacubitril/valsartan or ramipril. The primary outcome was cardiovascular death or incident HF. Baseline characteristics, clinical outcomes, and safety events were compared according to sex, a prespecified subgroup. Female participants were older and had more comorbidities. After multivariable adjustment, women and men were at similar risks for cardiovascular death or all-cause death. Women were more likely to have first HF hospitalization (hazard ratio [HR], 1.34 [95% CI, 1.05-1.70]; P=0.02) and total HF hospitalizations (HR, 1.39 [95% CI, 1.05-1.84]; P=0.02). Sex did not significantly modify the treatment effect of sacubitril/valsartan compared with ramipril on the primary outcome (P for interaction=0.11). Conclusions In contemporary patients who presented with reduced left ventricular ejection fraction, pulmonary congestion, or both, following acute myocardial infarction, women had a higher incidence of HF during follow-up. Sex did not modify the treatment effect of sacubitril/valsartan relative to ramipril. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02924727.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

September 5, 2023

Volume

12

Issue

17

Start / End Page

e028942

Location

England

Related Subject Headings

  • Ventricular Function, Left
  • Valsartan
  • Stroke Volume
  • Sex Characteristics
  • Ramipril
  • Myocardial Infarction
  • Male
  • Humans
  • Heart Failure
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wang, X., Jering, K. S., Cikes, M., Tokmakova, M. P., Mehran, R., Han, Y., … Solomon, S. D. (2023). Sex Differences in Clinical Characteristics and Outcomes After Myocardial Infarction With Low Ejection Fraction: Insights From PARADISE-MI. J Am Heart Assoc, 12(17), e028942. https://doi.org/10.1161/JAHA.122.028942
Wang, Xiaowen, Karola S. Jering, Maja Cikes, Mariya P. Tokmakova, Roxana Mehran, Yaling Han, Cara East, et al. “Sex Differences in Clinical Characteristics and Outcomes After Myocardial Infarction With Low Ejection Fraction: Insights From PARADISE-MI.J Am Heart Assoc 12, no. 17 (September 5, 2023): e028942. https://doi.org/10.1161/JAHA.122.028942.
Wang X, Jering KS, Cikes M, Tokmakova MP, Mehran R, Han Y, et al. Sex Differences in Clinical Characteristics and Outcomes After Myocardial Infarction With Low Ejection Fraction: Insights From PARADISE-MI. J Am Heart Assoc. 2023 Sep 5;12(17):e028942.
Wang, Xiaowen, et al. “Sex Differences in Clinical Characteristics and Outcomes After Myocardial Infarction With Low Ejection Fraction: Insights From PARADISE-MI.J Am Heart Assoc, vol. 12, no. 17, Sept. 2023, p. e028942. Pubmed, doi:10.1161/JAHA.122.028942.
Wang X, Jering KS, Cikes M, Tokmakova MP, Mehran R, Han Y, East C, Mody FV, Wang Y, Lewis EF, Claggett B, McMurray JJV, Granger CB, Pfeffer MA, Solomon SD. Sex Differences in Clinical Characteristics and Outcomes After Myocardial Infarction With Low Ejection Fraction: Insights From PARADISE-MI. J Am Heart Assoc. 2023 Sep 5;12(17):e028942.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

September 5, 2023

Volume

12

Issue

17

Start / End Page

e028942

Location

England

Related Subject Headings

  • Ventricular Function, Left
  • Valsartan
  • Stroke Volume
  • Sex Characteristics
  • Ramipril
  • Myocardial Infarction
  • Male
  • Humans
  • Heart Failure
  • Female