title: Gender and myocardial salvage after reperfusion treatment in acute myocardial infarction.
abstract: OBJECTIVE
  The aim of this study was to investigate whether there are gender-associated differences in the amount of myocardial salvage after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).
  
  
  BACKGROUND
  Despite having a more adverse cardiovascular risk profile, women with AMI have similar or even better outcomes after primary PCI compared with men. The reasons for these findings are unclear.
  
  
  METHODS
  In this study we included 202 women and 561 men with AMI who underwent primary PCI in the setting of three randomized trials. The primary end point of the study was myocardial salvage index (proportion of initial perfusion defect salvaged by reperfusion therapy), obtained by paired scintigraphic studies performed 7 to 10 days apart.
  
  
  RESULTS
  The amount of myocardium at risk or initial perfusion defect (median [25th, 75th percentiles]) did not differ significantly between women and men (22.0% [12.0, 40.0] vs. 24.0% [14.0, 39.0] of the left ventricle [LV], p = 0.26). Final infarct size, measured in the follow-up scintigraphy, was significantly smaller in women than in men (6.0% [0.71, 18.7] vs. 10.0% [3.9, 21.8] of the LV, p = 0.001). Myocardial salvage index was 0.64 (0.35, 0.95) in women versus 0.50 (0.26, 0.77) in men (p < 0.001). After adjustment for baseline characteristics, female gender was an independent predictor of greater myocardial salvage after PCI (p = 0.002).
  
  
  CONCLUSIONS
  The efficacy of primary PCI in patients with AMI appears to be gender-dependent. Myocardial salvage achieved by primary PCI is greater in women than in men.
authors.affiliation: Deutsches Herzzentrum, Technischen Universität, Munich, Germany. mehilli@dhm.mhn.de
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Stephan G
authors.initials: SG
authors.lastname: Nekolla
authors.forename: Christina
authors.initials: C
authors.lastname: Markwardt
authors.forename: Hildegard
authors.initials: H
authors.lastname: Bollwein
authors.forename: Jürgen
authors.initials: J
authors.lastname: Pache
authors.forename: Stefan
authors.initials: S
authors.lastname: Martinoff
authors.forename: Josef
authors.initials: J
authors.lastname: Dirschinger
authors.forename: Markus
authors.initials: M
authors.lastname: Schwaiger
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000473:pathology*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012737:Sex Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality; D016019:Survival Analysis; D016896:Treatment Outcome