{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T01:46:34Z","timestamp":1784339194612,"version":"3.55.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"CardioPaTh PhD"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The aim of the study is to evaluate the impact of sex on acute myocardial infarction (AMI) patients\u2019 clinical presentation and outcomes, comparing those with non-obstructive and obstructive coronary arteries (MINOCA vs. MIOCA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We enrolled 2455 patients with AMI undergoing coronary angiography from January 2017 to September 2021. Patients were divided according to the type of AMI and sex: male (n = 1593) and female (n = 607) in MIOCA and male (n = 87) and female (n = 168) in MINOCA. Each cohort was further stratified based on age (\u2264\/&amp;gt; 70 years). The primary endpoint (MAE) was a composite of all-cause death, recurrent AMI, and hospitalization for heart failure (HF) at follow-up. Secondary outcomes included all-cause and cardiovascular death, recurrent AMI, HF re-hospitalization, and stroke. MINOCA patients were more likely to be females compared with MIOCA ones (P &amp;lt; 0.001). The median follow-up was 28 (15\u201341) months. The unadjusted incidence of MAE was significantly higher in females compared with males, both in MINOCA [45 (26.8%) vs. 12 (13.8%); P = 0.018] and MIOCA cohorts [203 (33.4%) vs. 428 (26.9%); P = 0.002]. Age was an independent predictor of MAE in both cohorts. Among MINOCA patients, females \u226470 years old had a higher incidence of MAE [18 (23.7%) vs. 4 (5.9%); P = 0.003] compared with male peers, mainly driven by a higher rate of re-hospitalization for HF (P = 0.045) and recurrence of AMI (P = 0.006). Only in this sub-group of MINOCA patients, female sex was an independent predictor of MAE (hazard ratio = 3.09; 95% confidence interval: 1.02\u20139.59; P = 0.040). MINOCA females \u226470 years old had worse outcomes than MIOCA female peers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>MINOCA females \u226470 years old had a significantly higher incidence of MAE, compared with males and MIOCA female peers, likely due to the different pathophysiology of the ischaemic event.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration<\/jats:title>\n                  <jats:p>Data were part of the ongoing observational study \u2018AMIPE: Acute Myocardial Infarction, Prognostic and Therapeutic Evaluation\u2019 (ClinicalTrials.gov Identifier: NCT03883711).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuad059","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T14:19:06Z","timestamp":1685542746000},"page":"604-614","source":"Crossref","is-referenced-by-count":24,"title":["Sex- and age-related differences in outcomes of patients with acute myocardial infarction: MINOCA vs. MIOCA"],"prefix":"10.1093","volume":"12","author":[{"given":"Lisa","family":"Canton","sequence":"first","affiliation":[{"name":"Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"},{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, University of Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9198-2817","authenticated-orcid":false,"given":"Damiano","family":"Fedele","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"},{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, University of Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Bergamaschi","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"},{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, University of Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Fo\u00e0","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"},{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, University of Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ornella","family":"Di Iuorio","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"},{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, University of Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Pio","family":"Tattilo","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"},{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, University of Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"},{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, University of Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Angeli","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"},{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, IRCCS Azienda Ospedaliera-Universitaria di 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Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, University of Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Casuso","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"},{"name":"Department of Medical and Surgical Sciences\u2014DIMEC, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, University of Bologna , Via Giuseppe Massarenti 9, 40138 Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Belmonte","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium"},{"name":"Department of Advanced Biomedical Sciences, 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