Gender differences in efficacy of primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction.
BACKGROUND
The clinical outcome of percutaneous coronary intervention (PCI) is poorer in women than that in men. This study aimed at comparing the impact of gender difference on the strategy of primary PCI in patients with acute ST-segment elevation myocardial infarction (STEMI).


METHODS
Two hundred and fifty-nine patients with STEMI who underwent primary PCI within 12 hours of symptom onset were enrolled. The male group consisted of 143 men aged > 55 years, and a female group included 116 women without age limitation. Procedural success was defined as residual stenosis < 20% with thrombolysis in myocardial infarction flow grade > 2 and without death, emergency bypass surgery or disabling cerebral events during the hospitalization. The rate of major adverse cardiac events (MACE), including death, nonfatal myocardial infarction and target vessel revascularization during follow-up, was recorded.


RESULTS
Female patients were more hypertensive and diabetic and with fewer cigarette smokers than male counterparts. The prevalence of angiographic 3-vessel disease was higher in the female group, but the procedural success rate was comparable between the two groups (94.4% vs 92.2%). The occurrence rate of MACE did not differ during the hospitalization (4.2% vs 6.0%, P = 0.50), but was significantly higher in the female group during follow-up (mean (16.0 +/- 11.2) months) than that in the male group (5.4% vs 0.7%, P = 0.02).


CONCLUSIONS
Despite a similar success rate of primary PCI and in-hospital outcomes in both genders, female patients with acute STEMI still have a worse prognosis during the long-term follow-up.
Liu
Yu
Y
Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Wang
Le-feng
LF
Yang
Xin-fhun
XF
Ge
Yong-gui
YG
Wang
Hong-ghi
HG
Xu
Li
L
Li
Wei-ming
WM
Ni
Zhu-hua
ZH
Xia
Kun
K
Chi
Yong-hui
YH
Li
Qiang
Q
Zhang
Da-peng
DP
Wu
Xiao-qing
XQ
Sun
Hao
H
Guo
Zong-sheng
ZS
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D012737:Sex Factors; D016896:Treatment Outcome