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. 2022 Apr 1;23(4):234-241.
doi: 10.2459/JCM.0000000000001300.

Female gender and mortality in ST-segment-elevation myocardial infarction treated with primary PCI

Umberto Paradossi  1 , Nevio Taglieri  2 , Giulia Massarelli  2 , Cataldo Palmieri  1 , Alberto Ranieri De Caterina  1 , Antonio Giulio Bruno  2 , Alessandro Taddei  1 , Elena Nardi  2 , Gabriele Ghetti  2 , Tullio Palmerini  2 , Giuseppe Trianni  1 , Annamaria Mazzone  1 , Carmine Pizzi  2 , Francesco Donati  2 , Francesco Bendandi  2 , Cinzia Marrozzini  2 , Marcello Ravani  1 , Nazzareno Galiè  2 , Francesco Saia  2 , Sergio Berti  1
Affiliations

Female gender and mortality in ST-segment-elevation myocardial infarction treated with primary PCI

Umberto Paradossi et al. J Cardiovasc Med (Hagerstown). .

Abstract

Aims: To investigate gender difference in mortality among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous angioplasty (PPCI).

Methods: We analyzed data from the prospective registries of two hub PPCI centres over a 10-year period to assess the role of female gender as an independent predictor of both all-cause and cardiac death at 30 days and 1 year. To account for all confounding variables, a propensity score (PS)-adjusted multivariable Cox regression model and a PS-matched comparison between the male and female were used.

Results: Among 4370 consecutive STEMI patients treated with PPCI at participating centres, 1188 (27.2%) were women. The survival rate at 30 days and 1 year were significantly lower in women (Log-rank P-value < 0.001). At PS-adjusted multivariable Cox regression analysis, female gender was independently associated with an increased risk of 30-day all-cause death [hazard ratio (HR) = 2.09; 95% confidence interval (CI): 1.45-3.01, P < 0.001], 30-day cardiac death (HR = 2.03;95% CI:1.41-2.93, P < 0.001), 1-year all-cause death (HR = 1.45; 95% CI:1.16-1.82, P < 0.001) and 1-year cardiac death (HR = 1.51; 95% CI:1.15-1.97, P < 0.001). For the study outcome, we found a significant interaction of gender with the multivessel disease in females who were at increased risk of mortality in comparison with men in absence of multivessel disease. After the PS matching procedure, a subset of 2074 patients were identified. Women still had a lower survival rate and survival free from cardiac death rate both at 30-day and at 1-year follow-up.

Conclusion: As compared with men, women with STEMI treated with PPCI have higher risk of both all-cause death and cardiac mortality at 30-day and 1-year follow-up.

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References

    1. O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol 2013; 61:e78–e140.
    1. Steg PG, James SK, Atar D, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J 2012; 33:2569–2619.
    1. Saia F, Marrozzini C, Ortolani P, et al. Optimisation of therapeutic strategies for ST-segment elevation acute myocardial infarction: the impact of a territorial network on reperfusion therapy and mortality. Heart 2009; 95:370–376.
    1. Lempereur M, Magne J, Cornelis K, et al. Impact of gender difference in hospital outcomes following percutaneous coronary intervention. results of the Belgian Working Group on Interventional Cardiology (BWGIC) registry. EuroIntervention 2016; 12:e216–e223.
    1. Leurent G, Garlantezec R, Auffret V, et al. Gender differences in presentation, management and inhospital outcome in patients with ST-segment elevation myocardial infarction: data from 5000 patients included in the orbi prospective french regional registry. Arch Cardiovasc Dis 2014; 107:291–298.