Sex-related differences after contemporary primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

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• 作者：Olivier Barthé ; lé ; my ; ¹ ; ^{olivier.barthelemy@psl.aphp.fr" class="auth_mail" title="E-mail the corresponding author} ; Philippe Degrell¹ ; Emmanuel Berman ; Mathieu Kerneis ; Thibaut Petroni ; Johanne Silvain ; Laurent Payot ; Remi Choussat ; Jean-Philippe Collet ; Gerard Helft ; Gilles Montalescot ; Claude Le Feuvre
• 关键词：Women ; Myocardial infarction ; Coronary angioplasty ; Sex
• 刊名：Archives of Cardiovascular Diseases
• 出版年：2015
• 出版时间：August-September 2015
• 年：2015
• 卷：108
• 期：8-9
• 页码：428-436
• 全文大小：888 K

文摘

Whether outcomes differ for women and men after percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) remains controversial.

Aim

To compare 1-year outcomes after primary PCI in women and men with STEMI, matched for age and diabetes.

Methods

Consecutive women with STEMI of < 24 hours’ duration referred (August 2007 to January 2011) for primary PCI were compared with men matched for age and diabetes. Rates of all-cause mortality, target vessel revascularization (TVR) and major cardiovascular and cerebrovascular events (MACCE) (death/myocardial infarction/stroke) were assessed at 1 year.

Results

Among 775 consecutive patients, 182 (23.5%) women were compared with 182 matched men. Mean age was 69 ± 15 years, 18% had diabetes. Patient characteristics were similar, except for lower creatinine clearance (73 ± 41 vs 82 ± 38 渭mol/L; P = 0.041), more cardiogenic shock (14.8% vs 6.6%; P = 0.017) and less radial PCI (81.3% vs 90.1%; P = 0.024) in women. Rates of 1-year death (22.7% vs 18.1%), TVR (8.3% vs 6.0%) and MACCE (24.3% vs 20.9%) were not statistically different in women (P > 0.05 for all). After exclusion of patients with shock (10.7%) and out-of-hospital cardiac arrest (6.6%), death rates were even more similar (11.3% vs 11.8%; P = 0.10). Female sex was not independently associated with death (odds ratio 1.01, 95% confidence interval 0.55–1.87; P = 0.97).

Conclusion

In our consecutive unselected patient population, women had similar 1-year outcomes to men matched for age and diabetes, after contemporary primary PCI for STEMI, despite having a higher risk profile at baseline.