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J Clin Med. 2018 Dec 3;7(12). pii: E509. doi: 10.3390/jcm7120509.

Evolution of ST-Elevation Acute Myocardial Infarction Prevalence by Gender Assessed Age Pyramid Analysis-The Piramyd Study.

Author information

1
Registry Department, Regional Health Agency in Great Paris Area, 75008 Paris, France. aurelie.loyeau@sesan.fr.
2
Ramsay Générale de Santé, ICPS, 6 Avenue du Noyer Lambert à Massy, 91300 Massy, France. h.benamer@angio-icps.com.
3
Service de cardiologie Hôpital Européen de Paris-La Roseraie, 93300 Aubervilliers, France. h.benamer@angio-icps.com.
4
Registry Department, Regional Health Agency in Great Paris Area, 75008 Paris, France. s.bataille@orange.fr.
5
SAMU 93, UF Recherche-Enseignement-Qualité Avicenne Hospital-APHP, 93000 Bobigny, France. st.sarah.tepper@gmail.com.
6
Université Paris 13, Sorbonne Paris Cité, 75008 Paris, France. st.sarah.tepper@gmail.com.
7
SAMU 94 Mondor Hospital-APHP, 94000 Créteil, France. thevy.boche@gmail.com.
8
SAMU 94 Mondor Hospital-APHP, 94000 Créteil, France. lionel@lamhaut.fr.
9
SAMU de Paris ⁻ DAR, Necker Hospital-APHP, 75008 Paris, France. lionel@lamhaut.fr.
10
Université Paris Descartes, 75008 Paris, France. lionel@lamhaut.fr.
11
INSERM U 970 équipe 4, 75008 Paris, France. lionel@lamhaut.fr.
12
SAMU 77, Melun Hospital, 77000 Melun, France. virginie.pires@ch-melun.fr.
13
SAMU 91, Sud Francilien Hospital, 91100 Corbeil-Essonnes, France. benoitsimon1981@gmail.com.
14
SAMU 95, Pontoise Hospital, 95032 Pontoise, France. francois.dupas@ch-pontoise.fr.
15
SAMU 93, UF Recherche-Enseignement-Qualité Avicenne Hospital-APHP, 93000 Bobigny, France. lweisslinger@hotmail.fr.
16
Université Paris 13, Sorbonne Paris Cité, 75008 Paris, France. lweisslinger@hotmail.fr.
17
SAMU 92, Garches Hospital-APHP, 92380 Garches, France. gaelle.le-bail@wanadoo.fr.
18
Fire Departement of Paris, EMS Department, 75008 Paris, France. alexandre.allonneau@pompiersparis.fr.
19
Cardiology Department, DHU FIRE, Université Paris Diderot, Sorbonne Paris-Cité, INSERM U-1148, Bichat Hospital-APHP, 75008 Paris, France. jean-michel.juliard@aphp.fr.
20
SAMU 78, Versailles Hospital, 78150 Le Chesnay, France. yl.samu78@wanadoo.fr.
21
SAMU 93, UF Recherche-Enseignement-Qualité Avicenne Hospital-APHP, 93000 Bobigny, France. frederic.lapostolle@aphp.fr.
22
Université Paris 13, Sorbonne Paris Cité, 75008 Paris, France. frederic.lapostolle@aphp.fr.

Abstract

INTRODUCTION:

Recent studies reported a decrease in the incidence of acute myocardial infarction. This favorable evolution does not extend to young women. The interaction between gender, risk factors and myocardial infarction incidence remains controversial.

OBJECTIVE:

To compare the evolution of the age pyramid of patients with ST-elevation myocardial infarction (STEMI) according to gender.

METHODS:

Data from patients with STEMI managed in pre-hospital settings prospectively collected in the greater Paris area. Evolution of patient demographics and risk factors was investigated.

RESULTS:

28,249 patients with STEMI were included in the registry between 2002 and 2014, 21,883 (77%) males and 6,366 (23%) females. The sex ratio did not significantly vary over the study period (p = 0.4). Median patient age was 60.1 years (51.1⁻73.0) and was significantly different between males and females, respectively 57.9 (50.0⁻68.3) vs. 72.9 years (58.3⁻82.2) (p = 0.0004). The median age of males significantly (p = 0.0044) increased from 57.6 (50.1⁻70.0) in 2002 to 58.1 years (50.5⁻67.8) in 2014. The median age of females significantly (p = 0.0006) decreased from 73.7 (57.9⁻81.8) to 69.6 years (57.0⁻82.4). The median gap between the age of men and women significantly (p = 0.0002) decreased, from 16.1 to 11.5 years. Prevalence of risk factors was unchanged or decreased except for hypertension which significantly increased in males. The rate of STEMI without reported risk factors increased in both males and females.

CONCLUSION:

The age of STEMI onset significantly decreased in females, whereas it significantly increased in males. The prevalence of risk factors decreased in males, whereas no significant variation was found in females.

KEYWORDS:

ST-elevation myocardial infarction (STEMI); age; age pyramid; gender; prehospital

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