Age and sex differences in perioperative myocardial infarction after cardiac surgery

We investigate age and sex differences in acute myocardial infarction (AMI) after cardiac surgery in a prospective study of 2038 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass. An age of ≥70 years implied changes in the type of AMI from the ST-segment elevation myocardial infarction (STEMI) to non-STsegment elevation myocardial infarction (non-STEMI). Men were more likely than women to suffer from AMI after cardiac surgery (11.8% vs. 5.6%), as a result of the higher frequency of STEMI (6% of men vs. 1.8% of women; P< 0.001) in both age groups. A troponin-I (Tn-I) peak was significantly higher in patients ≥70 years old. In-hospital mortality was higher in patients ≥70 (7.3%) than in those <70 years old (3.3%), because of the increased mortality observed in men with non-AMI (2.1% vs. 6.3%) and women with STEMI (0% vs. 28.6%) and non-STEMI (0% vs. 36.8%, P< 0.05). Old age was associated with a higher frequency of non-STEMI, Tn-I peak, mortality and length of stay in the intensive care unit (ICU). Regardless of age, men more often suffer from AMI (particularly STEMI). AMI in women had a notable impact on excess mortality and ICU stay observed in patients ≥70 years of age. Clinical and Tn-I peak differences are expected in relation to age and gender after AMI post-cardiac surgery.