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. 2021 Dec 6;10(23):5716.
doi: 10.3390/jcm10235716.

The Effect of Periprocedural Clinical Factors Related to the Course of STEMI in Men and Women Based on the National Registry of Invasive Cardiology Procedures (ORPKI) between 2014 and 2019

Janusz Sielski  1 , Karol Kaziród-Wolski  1 , Karolina Jurys  2 , Paweł Wałek  1 , Zbigniew Siudak  1
Affiliations

The Effect of Periprocedural Clinical Factors Related to the Course of STEMI in Men and Women Based on the National Registry of Invasive Cardiology Procedures (ORPKI) between 2014 and 2019

Janusz Sielski et al. J Clin Med. .

Abstract

Background: There are several sex-related differences in the course, management, and outcomes of ST-elevation myocardial infarction (STEMI). This study aimed to identify the risk factors that may affect the odds of procedure-related death in patients with STEMI.

Methods: The observational cohort study group consisted of 118,601 participants recruited from the National Registry of Invasive Cardiology Procedures (ORPKI).

Results: Procedure-related death occurred in 802 (1.0%) men and in 663 (1.7%) women. The odds of procedure-related death among women were significantly higher than among men (OR, 1.76; 95% CI, 1.59-1.95; p < 0.001). The probability of procedure-related mortality was highest in both men and women with cardiac arrest in the cath lab, critical stenosis of the left main coronary artery, and direct transfer to the cath lab. The factors that reduced the probability of procedure-related mortality in both men and women were thrombolysis in myocardial infarction (TIMI) flow grade and the use of P2Y12 inhibitors in the peri-infarct period. Psoriasis was associated with increased odds of procedure-related death among men, whereas cigarette smoking reduced the odds among women.

Conclusions: Procedure-related deaths occurred more frequently in women than men with STEMI. Additional scrutiny needs to be undertaken to identify factors influencing survival regarding gender differences.

Keywords: acute coronary syndrome; myocardial infarction; percutaneous coronary intervention.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
General flow chart of patients. OHCA—out of hospital cardiac arrest.
Figure 2
Figure 2
Factors that affect the probability of procedure-related mortality among men. Legend: BMS, bare metal stent; MI, myocardial infarction; GPI IIb/IIIa, IIb/IIIa, glycoprotein inhibitor; LAD, critical stenosis of left anterior descending artery; LMCA, critical stenosis of left main coronary artery; PCI, percutaneous coronary intervention; TIMI, thrombolysis in myocardial infarction.
Figure 3
Figure 3
Factors that affect the probability of procedure-related mortality among women. Legend: BMS, bare metal stent; DES, drug-eluting stent; MI, myocardial infarction; LAD, critical stenosis of left anterior descending artery; LMCA, critical stenosis of left main coronary artery; PCI, percutaneous coronary intervention; TIMI, thrombolysis in myocardial infarction.
See this image and copyright information in PMC

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