title: Gender-related outcome following percutaneous coronary intervention for ST-elevation myocardial infarction: data from the Austrian acute PCI registry.
abstract: OBJECTIVE
  Whether or not primary percutaneous coronary intervention (P-PCI) is equally effective and safe in women and men in a real world setting is still a matter of debate. The aim of this study was to evaluate the effect of gender on in-hospital outcome after P-PCI for ST-elevation myocardial infarction (STEMI) in a prospective national registry.
  
  
  RESULTS
  This registry includes in-hospital outcome data from 19 PCI-performing hospitals. During 12 months, 1087 patients with STEMI were registered (mean age 62 +/- 13 years; 27% women). Women were older than men (67 +/- 13 vs. 60 +/- 13 years; p < 0.001) and more often had diabetes mellitus (21% vs. 13%; p < 0.001) or cardiogenic shock (15% vs. 9%; p=0.004). PCI was performed in 1004 patients (92.4%) and more frequently in men than in women (93.9 vs. 88.3%, p=0.002), whereas conservative treatment was more often decided in women (9.3% vs 4.3%; p=0.002). No differences were found between women and men in primary success rate (TIMI 2+3 flow, 92.9% vs. 93%; p=0.96). On univariate analysis, in-hospital mortality was higher in women than in men (13.7% vs. 7.2%; p=0.001). On multivariable analysis age, shock, diabetes and TIMI flow before PCI remained associated with mortality.
  
  
  CONCLUSIONS
  Women have higher in-hospital mortality following PCI for STEMI. On multivariate analysis age, shock, diabetes and TIMI flow, but not gender, were associated with mortality in this national register. Older age and more comorbidity are likely to explain the higher mortality in female patients undergoing P-PCI.
authors.affiliation: Innsbruck Medical University, Division of Cardiology, Innsbruck, Austria.
authors.forename: Alois
authors.initials: A
authors.lastname: Suessenbacher
authors.forename: Jakob
authors.initials: J
authors.lastname: Doerler
authors.forename: Hannes
authors.initials: H
authors.lastname: Alber
authors.forename: Josef
authors.initials: J
authors.lastname: Aichinger
authors.forename: Johann
authors.initials: J
authors.lastname: Altenberger
authors.forename: Werner
authors.initials: W
authors.lastname: Benzer
authors.forename: Guenter
authors.initials: G
authors.lastname: Christ
authors.forename: Sebastian
authors.initials: S
authors.lastname: Globits
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.forename: Ronald
authors.initials: R
authors.lastname: Karnik
authors.forename: Georg
authors.initials: G
authors.lastname: Norman
authors.forename: Peter
authors.initials: P
authors.lastname: Siostrzonek
authors.forename: Gerald
authors.initials: G
authors.lastname: Zenker
authors.forename: Otmar
authors.initials: O
authors.lastname: Pachinger
authors.forename: Franz
authors.initials: F
authors.lastname: Weidinger
mesh_terms: D017677:Age Distribution; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D001317:Austria / Q000453:epidemiology; D015897:Comorbidity; D003326:Coronary Circulation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D011237:Predictive Value of Tests; D012042:Registries / Q000706:statistics & numerical data; D017678:Sex Distribution; D016896:Treatment Outcome