Very Long-Term Outcomes after Acute Myocardial Infarction in Young Men and Women: Insights from the FAST-MI Program.

Aims: Conflicting data exists about long-term outcomes in young women and men experiencing acute myocardial infarction (AMI). Methods: The FAST-MI program consists of three nationwide French surveys carried out 5 years apart from 2005 to 2015, including consecutive patients with AMI over a 1-month period with up to 10-year follow-up. The present analysis focused on adults & LE; 50 yo according to their gender.Results: Women accounted for 17.5% (335) of the 1912 patients under 50 yo and had a similar age as men (43.9 & PLUSMN; 5.1 vs. 43.9 & PLUSMN; 5.5 years, P = 0.92). They received less percutaneous coronary interventions (PCI) than men (85.9% vs. 91.3%, P = 0.005), even in ST-elevation myocardial infarction (83.6% vs. 93.5%, P < 0.001). Recommended secondary prevention medications were less frequently prescribed at discharge in women (40.6% vs. 52.8%, P < 0.001), a trend that persisted in 2015 (59.1% vs. 72.8% in 2015, P < 0.001). Still, ten-year survival was similar in men (90.5%) and women (92.3%) (crude HR: 0.86 [95% CI: 0.55-1.35], P = 0.52, adjusted HR: 0.63 [95% CI: 0.38-1.07], P = 0.09); similar results were found for ten-year survival among hospital survivors (91.2% in men vs. 93.7% in women, adjusted HR: 0.87 [95% CI: 0.45-1.66], P = 0.66). Of the 1684 patients alive at hospital discharge with morbidity follow-up & GE; 6 months available, death, AMI or stroke at 8 years occurred in 12.9% men and 11.2% in women (adjusted HR: 0.90 [95% CI: 0.60-1.33], P = 0.59).Conclusions: Young women with AMI undergo less cardiac interventions and are less often prescribed secondary prevention treatment than men, even when significant coronary artery disease is present, but keep a similar long-term prognosis after AMI. Optimal management of these young patients, regardless of gender, is necessary to ensure best outcomes after this major cardiovascular event.& COPY; 2023 Elsevier Masson SAS. All rights reserved.