• Alicia Jeanette Fischer, Jannik Feld, Lena Makowski, Christiane Engelbertz, Leonie Kühnemund, Christian Günster, Patrik Dröge, Thomas Ruhnke, Joachim Gerß, Eva Freisinger, Holger Reinecke, and Jeanette Köppe.
• Department of Cardiology III: Congenital Heart Defects and Valvular Heart Disease, University Hospital Münster; Institute for Biostatistics and Clinical Research, University of Münster; Department of Cardiology I: Coronary Heart Disease, Heart Failure, and Angiology, University Hospital Münster; Research Institute of the AOK (WIdO), Berlin.
• Dtsch Arztebl Int. 2022 Apr 22; 119 (16): 284-292.

BackgroundSurvival after ST-elevation myocardial infarction (STEMI) as a first event in Germany was analyzed.MethodsAdults with a first-event STEMI were included for analysis on the basis of insurance data from a German health insurance provider (AOK; approximately 26 million members; median follow-up 48.5 months). The primary endpoints were 30-day mortality, reinfarction or death, major adverse cardiovascular and cerebro - vascular events (MACCE), long-term survival for more than 90 days, and overall survival (OS).ResultsSTEMI occurred in 17 444 patients (32.8% women). The women were older than the men (median age 74 versus 60 years) and suffered more frequently from cardiovascular comorbidities such as diabetes mellitus, chronic renal disease, and arterial hypertension. Women underwent endovascular or surgical treatment less frequently, but sustained complications (cardiogenic shock, resuscitation) more frequently. After adjustment of the data, women were at higher risk of 30-day mortality (odds ratio [OR] 1.17, 95% confidence interval [95% CI] [1.07; 1.28]), reinfarction or death (hazard ratio [HR] 1.09, 95% CI [1.04; 1.16]), MACCE (HR 1.09, 95% CI [1.04; 1.15]), and poorer OS (HR 1.10, 95% CI [1.04; 1.17]). This effect was especially pronounced in women aged ≤ 60 years. No differences between the sexes were seen among patients who survived for 90 days after the infarction.ConclusionIn Germany, women ≤ 60 years display a higher 30-day mortality after first-event STEMI, which affects their overall survival. Younger women should receive intensified medical attention after STEMI, especially in the early phase.

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