Does gender affect the clinical outcome of patients with acute myocardial infarction complicated by cardiogenic shock who undergo percutaneous coronary intervention?
This study sought to determine the impact of female gender on clinical outcome in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) due to predominant ventricular failure undergoing percutaneous coronary intervention (PCI). We analyzed gender-related differences in procedural, angiographic, and clinical outcomes in 208 consecutive patients with AMI complicated by CS. Out of 208 patients with CS, 65 were women and 143 men. Women were older than men (74 +/- 10 years vs. 66 +/- 12 years; P < 0.001) and had a greater incidence of a history of hypertension (43% vs. 29%; P = 0.041). The 6-month mortality rate was 42% in women and 31% in men (P = 0.157). There were no differences between groups in reinfarction rate and target vessel revascularization rate. Multivariate analysis showed age as the only variable independently related to the 6-month mortality, while female gender was not related to the risk of death. The benefit of early PCI is similar in women and men, and any potential referral bias in the use of PCI based on gender differences should be avoided.
Antoniucci
David
D
Division of Cardiology, Careggi Hospital, Florence, Italy. cardedept@tin.it
Migliorini
Angela
A
Moschi
Guia
G
Valenti
Renato
R
Trapani
Maurizio
M
Parodi
Guido
G
Bolognese
Leonardo
L
Santoro
Giovanni M
GM
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D012737:Sex Factors; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000401:mortality