The impact of gender on outcomes of patients with ST elevation myocardial infarction transported for percutaneous coronary intervention: analysis of the PRAGUE-1 and 2 studies.
BACKGROUND
Data comparing survival outcomes for women versus men transported for pPCI were absent.


OBJECTIVE
To assess the impact of gender on 30-day mortality of patients with STEMI transported for pPCI.


METHODS
The data from the PRAGUE-1 and PRAGUE-2 trials were analysed. Studies compared thrombolysis in the community hospital and pPCI after transportation to cardiocentre. A group of 520 patients treated with thrombolysis, and 530 transported for pPCI, were analysed.


RESULTS
Women were older, with a higher risk profile. They had longer ischaemia time. Mortality of patients treated with TL was significantly higher in women than in men (15% vs 9%, p = 0.043). There was no significant gender difference in mortality in the PCI group (8.2% of women vs 6.2% of men, p = 0.409). Mortality of women treated with on-site TL was nearly twice as high as mortality of women transported for pPCI (p = 0.043). After adjustment in a multivariate model the odds ratio for mortality in women was 0.74 (95% CI 0.26 to 2.05; p = 0.556).


CONCLUSIONS
Long-distance transportation of women with STEMI from a community hospital to a tertiary PCI centre is a significantly more effective treatment strategy than on-site TL. Gender did not determine survival in patients transported for pPCI.
Motovska
Z
Z
3rd Faculty of Medicine, Charles University and Cardiocentre Kralovske Vinohrady, Prague, Czech Republic. zuzana.motovska@iex.cz
Widimsky
P
P
Aschermann
M
M
D017677:Age Distribution; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D006328:Cardiac Catheterization / Q000379:methods / Q000401:mortality; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods / Q000401:mortality; D010360:Patient Transfer / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D015912:Thrombolytic Therapy / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome