Sex-Based Differences in Unrecognized Myocardial Infarction

M. Yldau van der Ende; Luis Eduardo Juarez-Orozco; Ingmar Waardenburg; Erik Lipsic; Remco A. J. Schurer; Hindrik W. van der Werf; Emelia J. Benjamin; Dirk Jan van Veldhuisen; Harold Snieder; Pim van der Harst

doi:10.1161/JAHA.119.015519

Sex-Based Differences in Unrecognized Myocardial Infarction

M. Yldau van der Ende, Luis Eduardo Juarez-Orozco, Ingmar Waardenburg, Erik Lipsic, Remco A. J. Schurer, Hindrik W. van der Werf, Emelia J. Benjamin, Dirk Jan van Veldhuisen, Harold Snieder, Pim van der Harst^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

7 Citations (Scopus)

57 Downloads (Pure)

Abstract

BACKGROUND: Myocardial infarction is an important cause of morbidity and mortality in both men and women. Atypical or the absence of symptoms, more prevalent among women, may contribute to unrecognized myocardial infarctions and missed opportunities for preventive therapies. The aim of this research is to investigate sex-based differences of undiagnosed myocardial infarction in the general population.

METHODS AND RESULTS: In the Lifelines Cohort Study, all individuals >= 18 years with a normal baseline ECG were followed from baseline visit till first follow-up visit (approximate to 5 years, n=97 203). Individuals with infarct-related changes between baseline and follow-up ECGs were identified. The age- and sex-specific incidence rates were calculated and sex-specific cardiac symptoms and predictors of unrecognized myocardial infarction were determined. Follow-up ECG was available after a median of 3.8 (25th and 75th percentile: 3.0-4.6) years. During follow-up, 198 women experienced myocardial infarction (incidence rate 1.92 per 1000 persons-years) compared with 365 men (incidence rate 3.30; P

CONCLUSIONS: A substantial proportion of myocardial infarctions are unrecognized, especially in women. Opportunities for secondary preventive therapies remain underutilized if myocardial infarction is unrecognized.

Original language	English
Article number	015519
Pages (from-to)	e015519
Number of pages	15
Journal	Journal of the American Heart Association
Volume	9
Issue number	13
DOIs	https://doi.org/10.1161/JAHA.119.015519
Publication status	Published - 7-Jul-2020

Keywords

cohort study
epidemiology
incidence
sex differences
unrecognized myocardial infarction
CARDIOVASCULAR-DISEASE
PREVALENCE
WOMEN
RISK
PROGNOSIS
MORTALITY
OLDER
MEN
ASSOCIATION
CARE

Access to Document

10.1161/JAHA.119.015519Licence: CC BY-NC-ND

Sex‐Based Differences in Unrecognized Myocardial InfarctionFinal publisher's version, 880 KBLicence: CC BY-NC-ND

Handle.net

Persistent link

Cite this

@article{fa9db1565b1b41cd8a98942b1aeda37d,

title = "Sex-Based Differences in Unrecognized Myocardial Infarction",

abstract = "BACKGROUND: Myocardial infarction is an important cause of morbidity and mortality in both men and women. Atypical or the absence of symptoms, more prevalent among women, may contribute to unrecognized myocardial infarctions and missed opportunities for preventive therapies. The aim of this research is to investigate sex-based differences of undiagnosed myocardial infarction in the general population.METHODS AND RESULTS: In the Lifelines Cohort Study, all individuals >= 18 years with a normal baseline ECG were followed from baseline visit till first follow-up visit (approximate to 5 years, n=97 203). Individuals with infarct-related changes between baseline and follow-up ECGs were identified. The age- and sex-specific incidence rates were calculated and sex-specific cardiac symptoms and predictors of unrecognized myocardial infarction were determined. Follow-up ECG was available after a median of 3.8 (25th and 75th percentile: 3.0-4.6) years. During follow-up, 198 women experienced myocardial infarction (incidence rate 1.92 per 1000 persons-years) compared with 365 men (incidence rate 3.30; PCONCLUSIONS: A substantial proportion of myocardial infarctions are unrecognized, especially in women. Opportunities for secondary preventive therapies remain underutilized if myocardial infarction is unrecognized.",

keywords = "cohort study, epidemiology, incidence, sex differences, unrecognized myocardial infarction, CARDIOVASCULAR-DISEASE, PREVALENCE, WOMEN, RISK, PROGNOSIS, MORTALITY, OLDER, MEN, ASSOCIATION, CARE",

author = "{van der Ende}, {M. Yldau} and Juarez-Orozco, {Luis Eduardo} and Ingmar Waardenburg and Erik Lipsic and Schurer, {Remco A. J.} and {van der Werf}, {Hindrik W.} and Benjamin, {Emelia J.} and {van Veldhuisen}, {Dirk Jan} and Harold Snieder and {van der Harst}, Pim",

year = "2020",

month = jul,

day = "7",

doi = "10.1161/JAHA.119.015519",

language = "English",

volume = "9",

pages = "e015519",

journal = "Journal of the American Heart Association",

issn = "2047-9980",

publisher = "Wiley",

number = "13",

}

TY - JOUR

T1 - Sex-Based Differences in Unrecognized Myocardial Infarction

AU - van der Ende, M. Yldau

AU - Juarez-Orozco, Luis Eduardo

AU - Waardenburg, Ingmar

AU - Lipsic, Erik

AU - Schurer, Remco A. J.

AU - van der Werf, Hindrik W.

AU - Benjamin, Emelia J.

AU - van Veldhuisen, Dirk Jan

AU - Snieder, Harold

AU - van der Harst, Pim

PY - 2020/7/7

Y1 - 2020/7/7

N2 - BACKGROUND: Myocardial infarction is an important cause of morbidity and mortality in both men and women. Atypical or the absence of symptoms, more prevalent among women, may contribute to unrecognized myocardial infarctions and missed opportunities for preventive therapies. The aim of this research is to investigate sex-based differences of undiagnosed myocardial infarction in the general population.METHODS AND RESULTS: In the Lifelines Cohort Study, all individuals >= 18 years with a normal baseline ECG were followed from baseline visit till first follow-up visit (approximate to 5 years, n=97 203). Individuals with infarct-related changes between baseline and follow-up ECGs were identified. The age- and sex-specific incidence rates were calculated and sex-specific cardiac symptoms and predictors of unrecognized myocardial infarction were determined. Follow-up ECG was available after a median of 3.8 (25th and 75th percentile: 3.0-4.6) years. During follow-up, 198 women experienced myocardial infarction (incidence rate 1.92 per 1000 persons-years) compared with 365 men (incidence rate 3.30; PCONCLUSIONS: A substantial proportion of myocardial infarctions are unrecognized, especially in women. Opportunities for secondary preventive therapies remain underutilized if myocardial infarction is unrecognized.

AB - BACKGROUND: Myocardial infarction is an important cause of morbidity and mortality in both men and women. Atypical or the absence of symptoms, more prevalent among women, may contribute to unrecognized myocardial infarctions and missed opportunities for preventive therapies. The aim of this research is to investigate sex-based differences of undiagnosed myocardial infarction in the general population.METHODS AND RESULTS: In the Lifelines Cohort Study, all individuals >= 18 years with a normal baseline ECG were followed from baseline visit till first follow-up visit (approximate to 5 years, n=97 203). Individuals with infarct-related changes between baseline and follow-up ECGs were identified. The age- and sex-specific incidence rates were calculated and sex-specific cardiac symptoms and predictors of unrecognized myocardial infarction were determined. Follow-up ECG was available after a median of 3.8 (25th and 75th percentile: 3.0-4.6) years. During follow-up, 198 women experienced myocardial infarction (incidence rate 1.92 per 1000 persons-years) compared with 365 men (incidence rate 3.30; PCONCLUSIONS: A substantial proportion of myocardial infarctions are unrecognized, especially in women. Opportunities for secondary preventive therapies remain underutilized if myocardial infarction is unrecognized.

KW - cohort study

KW - epidemiology

KW - incidence

KW - sex differences

KW - unrecognized myocardial infarction

KW - CARDIOVASCULAR-DISEASE

KW - PREVALENCE

KW - WOMEN

KW - RISK

KW - PROGNOSIS

KW - MORTALITY

KW - OLDER

KW - MEN

KW - ASSOCIATION

KW - CARE

U2 - 10.1161/JAHA.119.015519

DO - 10.1161/JAHA.119.015519

M3 - Article

SN - 2047-9980

VL - 9

SP - e015519

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

IS - 13

M1 - 015519

ER -