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. 2019 Jul 9;1(8):313-319.
doi: 10.1253/circrep.CR-19-0041.

Sex-Related Differences in In-Hospital Mortality in Japanese ST-Elevation Acute Myocardial Infarction Patients Presenting to Hospital in the 24 Hours After Symptom Onset - Results From K-ACTIVE

Sakura Nagumo  1 , Hiroyoshi Mori  1 , Atsuo Maeda  2 , Yoshihiro J Akashi  3 , Junya Ako  4 , Yuji Ikari  5 , Toshiaki Ebina  6 , Naoki Sato  7 , Kouichi Tamura  8 , Atsuo Namiki  9 , Kazuki Fukui  10 , Ichiro Michishita  11 , Kazuo Kimura  12 , Hiroshi Suzuki  1
Affiliations

Sex-Related Differences in In-Hospital Mortality in Japanese ST-Elevation Acute Myocardial Infarction Patients Presenting to Hospital in the 24 Hours After Symptom Onset - Results From K-ACTIVE

Sakura Nagumo et al. Circ Rep. .

Abstract

Background: Despite the drastic advances in clinical care for patients with acute ST-elevation myocardial infarction (STEMI), female STEMI patients have higher in-hospital mortality rates than male patients. This study assessed the influence of sex on in-hospital mortality in STEMI patients in Kanagawa Prefecture, Japan. Methods and Results: From October 2015 to June 2018, 2,491 consecutive STEMI patients (23.9% female) who presented to hospital in the 24 h after symptom onset were analyzed. The female patients were 9 years older and less frequently had diabetes, smoking and prior MI than male patients. Pre-hospital managements, including prehospital 12-lead electrocardiography, and symptom-to-door time were similar between the sexes. A door-to-device time ≤90 min was achieved in 61.3% of female cases and in 65.0% of male cases (P=0.13). Reperfusion therapy was provided to 94.6% of female and 97.6% of male patients (P<0.001). In-hospital mortality rate was not significantly different between female and male patients (6.6% vs. 7.8%, P=0.37). On multivariate logistic regression analysis, female sex itself was not associated with in-hospital mortality (OR, 1.52; 95% CI: 0.67-3.47, P=0.32). Conclusions: There was no sex discrepancy in the in-hospital mortality of STEMI patients in this study. Guideline-based treatment, such as advanced pre-hospital management and a high use of reperfusion therapy might have attenuated the sex-related differences in the in-hospital mortality.

Keywords: Female; In-hospital mortality; ST-elevation acute myocardial infarction.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Age distribution according to sex in patients with ST-elevation acute myocardial infarction in the Kanagawa-ACuTe cardIoVascular rEgistry (K-ACTIVE). (Blue) Male; (orange) female.
Figure 2.
Figure 2.
In-hospital mortality according to sex in patients with ST-elevation acute myocardial infarction in the Kanagawa-ACuTe cardIoVascular rEgistry (K-ACTIVE): (A) overall and (B) by age. (Blue) Male; (orange) female.
See this image and copyright information in PMC

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