Impact of female sex on long-term outcomes in patients with ST-elevation myocardial infarction treated by primary percutaneous coronary intervention.
Can J Cardiol
; 27(6): 749-55, 2011.
Article
em En
| MEDLINE
| ID: mdl-21924580
ABSTRACT
BACKGROUND:
Conflicting information exists about whether sex differences affect long-term outcomes in patients undergoing primary percutaneous coronary intervention (PCI).METHODS:
This retrospective study enrolled consecutive patients with ST-elevation myocardial infarction undergoing primary PCI within 24 hours from symptom onset. Hazard ratios (HRs) of events with 95% confidence interval (CI) were calculated in the overall population and in a propensity score matched cohort of women and men.RESULTS:
Among 481 patients, median age 66 years old, 138 (28.7%) were women. Women were older than men (72 vs 63 years, P<0.001), had a higher prevalence of hypertension (68% vs 54%, P=0.006), diabetes (27% vs 19%, P=0.04), and Killip class≥3 at admission (19% vs 10%, P=0.007). After a median follow-up of 1041 days women experienced a significant higher incidence of the composite of death, nonfatal myocardial infarction, and hospitalization for heart failure (31.9% vs 18.4%, unadjusted HR 1.86; 95% CI, 1.26-2.74; P=0.002), driven mainly by heart failure (unadjusted HR 2.47; 95% CI, 1.12-5.41; P=0.024), without significant differences in death (unadjusted HR 1.49; 95% CI, 0.88-2.53; P=0.13), or nonfatal myocardial infarction (unadjusted HR 1.59; 95% CI, 0.78-3.27; P=0.19) and no increase in target lesion revascularization (9.4% vs 12.5%, unadjusted HR 0.77; 95% CI, 0.42-1.44; P=0.42). After propensity score matching the hazard of the composite endpoint was largely attenuated (HR 1.32; 95% CI, 0.84-2.06; P=0.23).CONCLUSIONS:
Women undergoing primary PCI experience worse long-term outcomes than men, but this difference is largely explained by their more adverse baseline cardiovascular profile.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Angioplastia Coronária com Balão
/
Eletrocardiografia
/
Infarto do Miocárdio
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Can J Cardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Itália