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. 2011 May;34(5):294-301.
doi: 10.1002/clc.20916.

Gender-related differences in patients with ST-elevation myocardial infarction: results from the registry study of the ST elevation myocardial infarction network Essen

Birgit Hailer  1 , Christoph Naber, Bernd Koslowski, Peter van Leeuwen, Harald Schäfer, Thomas Budde, Rainer Jacksch, Georg Sabin, Raimund Erbel; Myocardial Infarction Network Essen
Affiliations

Gender-related differences in patients with ST-elevation myocardial infarction: results from the registry study of the ST elevation myocardial infarction network Essen

Birgit Hailer et al. Clin Cardiol. 2011 May.

Abstract

Background: The Myocardial Infarction Network Essen was initiated in order to establish a standardized procedure with immediate reopening of the infarcted vessel for patients with ST-elevation myocardial infarction (STEMI) in the city of Essen, Germany. The present study aims to evaluate gender-related differences in presentation of disease and clinical outcome.

Hypothesis: Gender is associated with differences in presentation and outcome of STEMI.

Methods: All patients with STEMI were included without exception. Parameters such as risk profile, mortality, and relevant time intervals were documented. The follow-up period was 1 year.

Results: For this study, 1365 patients (72.1% male) were recruited. Women were significantly older, with higher prevalence of diabetes (28.1% vs 20.3%, P = 0.004) and hypertension (76.5% vs 64.8%, P<0.0005). Analysis of time intervals between symptoms to actions showed no significant differences. However, women tended to wait longer before calling for medical assistance (358 vs 331 min, P = 0.091). In-hospital mortality was comparable with respect to gender, whereas women had higher 1-year mortality (18.6% vs 13.2%). Age and diabetes were associated with a higher mortality. Adjusted for age, gender is no longer an independent risk factor. In the follow-up period, significantly more women were readmitted to the hospital without a difference in the frequency of reangiography, surgery, or target-vessel revascularization.

Conclusions: The present data display a successful implementation of a standardized procedure in patients with STEMI. Although differences between genders are not as obvious as expected, efforts should be taken to perform a gender-specific risk analysis as well as to promote education about proper behavior in case of new onset of angina.

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Figures

Figure 1
Figure 1
Boxplots of time to balloon inflation with respect to gender and mortality. P value is given for the comparison between groups (Mann‐Whitney U test). Abbreviations: nS, nonsurvivors; S, survivors.
Figure 2
Figure 2
Mortality with respect to gender. P value is given for the comparison between groups (Fisher exact test, P < 0.05 in bold).
See this image and copyright information in PMC

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