[Therapeutic approach and mortality in men and women with ST-segment elevation myocardial infarction]. / Strategia leczenia a smiertelnosc kobiet i mezczyzn z zawalem serca z uniesieniem odcinka.

ABSTRACT

UNLABELLED The benefit of immediate reperfusion in the treatment of ST-segment elevation myocardial infarction (STEMI) is indisputable. Unfortunately, no reperfusion therapy is applied to nearly 30% of patients without contraindication to such treatment. We aimed to analyze the impact of therapeutic approach on the prognosis after acute phase of STEMI. MATERIAL AND METHODS: The study group consisted of 26035 consecutive STEMI patients (8989 females, 34.4%) hopitalized in 456 sites during one year. Data were available from the Polish Registry of Acute Coronary Syndromes (PL-ACS) launched in Silesian Center for Heart Diseases, Zabrze. RESULTS: Patiens treated with primary percutaneous intervention (pPCI) had the best outcome. All therapeutic strategies resulted in worse prognosis in women when compared to men. Women had greater 12-month mortality in the conservative, fibrinolytic and interventional treatment group 33.1% vs 23.2%; p < 0.0001; 24.3% vs 16.2%; p < 0.0001 i 11.4% vs 8.2%, p < 0.0001, respectively. Differences in the surgically treated group were insignificant (men 25%, women 8%, p = 0.42). CONCLUSIONS: The outcome of conservative, fibrinolytic and interventional treatment was worse in the female group. Primary coronary angioplasty was the most benefical therapeutic strategy.