title: Gender-related differences in mortality after ST-segment elevation myocardial infarction: a large multicentre national registry.
abstract: OBJECTIVE
  Clinical outcomes in the treatment of acute ST-segment elevation myocardial infarction (STEMI) differ between men and women. The aim of the study was to compare results of STEMI management in a large multicentre national registry.
  
  
  RESULTS
  A total of 456 hospitals (including 58 interventional centres) participated in the registry during one year. The study group consisted of 8,989 (34.5%) females and 17,046 (65.5%) males. Women were older (69.7 ± 11 vs. 62 ± 12 years; p<0.0001) and had more risk factors. Percutaneous coronary intervention was performed significantly less in women (47.8% vs. 57.4%; p<0.0001). There was a longer time delay in women at each stage of treatment. The incidence of in-hospital complications was higher in women. In-hospital (11.9% vs. 6.9%; p<0.0001) and 12-months (22% vs. 14.1%; p<0.0001) mortality was significantly higher in women. In multivariate analysis pulmonary oedema, cardiogenic shock, cardiac arrest, age, diabetes and anterior infarction significantly increased both in-hospital and long-term mortality. The in-hospital mortality was higher in the female group.
  
  
  CONCLUSIONS
  Despite poor clinical characteristics, less than satisfactory management and a worse prognosis of STEMI in women, being a women itself is not a risk factor for increased long-term mortality, however, other well known risk factors affecting the prognosis relate frequently to the female gender.
authors.affiliation: Swietokrzyskie Centrum Kardiologii, Kielce, Poland. emsad@o2.pl
authors.forename: Marcin
authors.initials: M
authors.lastname: Sadowski
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gasior
authors.forename: Marek
authors.initials: M
authors.lastname: Gierlotka
authors.forename: Marianna
authors.initials: M
authors.lastname: Janion
authors.forename: Lech
authors.initials: L
authors.lastname: Poloński
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality* / Q000706:statistics & numerical data; D002317:Cardiovascular Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054624:Health Status Disparities; D054625:Healthcare Disparities; D017052:Hospital Mortality; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D016017:Odds Ratio; D011044:Poland / Q000453:epidemiology; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014187:Transportation of Patients / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents