Gender differences in clinical features and in-hospital outcomes in ST-segment elevation acute myocardial infarction: from the Korean Acute Myocardial Infarction Registry (KAMIR) study.
BACKGROUND
Studies have suggested that women are biologically different and that female gender itself is independently associated with poor clinical outcome after an acute myocardial infarction (AMI).


OBJECTIVE
We analyzed data from the Korean Acute Myocardial Infarction Registry (KAMIR) to assess gender differences in in-hospital outcomes post ST-segment elevation myocardial infarction (STEMI).


METHODS
Between November 2005 and July 2007, 4037 patients who were admitted with STEMI to 41 facilities were registered into the KAMIR database; patients admitted within 72 hours of symptom onset were selected and included in this study.


RESULTS
The proportion of patients who had reperfusion therapy within 12 hours from chest pain onset was lower in women. Women had higher rates of in-hospital mortality (8.6% vs 3.2%, P < .01), noncardiac death (1.5% vs 0.4%, P < .01), cardiac death (7.1% vs 2.8%, P < .01), and stroke (1.2% vs 0.5%, P < .05) than men. Multivariate logistic regression analysis identified age, previous angina, hypertension, a Killip class > or = II, a left ventricular ejection fraction (LVEF) < 40%, and a thrombolysis in myocardial infarction flow (TIMI) grade < or = 3 after angioplasty as independent risk factors for in-hospital death for all patients; however, female gender itself was not an independent risk factor.


CONCLUSIONS
The results of this study show that although women have a higher in-hospital mortality than men, female gender itself is not an independent risk factor for in-hospital mortality.
Park
Jong-Seon
JS
Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
Kim
Young-Jo
YJ
Shin
Dong-Gu
DG
Jeong
Myung-Ho
MH
Ahn
Young-Keun
YK
Chung
Wook-Sung
WS
Seung
Ki-Bae
KB
Kim
Chong-Jin
CJ
Cho
Myeong-Chan
MC
Jang
Yang-Soo
YS
Park
Seung-Jung
SJ
Seong
In-Whan
IW
Chae
Shung-Chull
SC
Hur
Seung-Ho
SH
Choi
Dong-Hoon
DH
Hong
Taek-Jong
TJ
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000009:adverse effects / Q000401:mortality; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome