title: Female gender is an independent predictor of in-hospital mortality after STEMI in the era of primary PCI: insights from the greater Paris area PCI Registry.
abstract: OBJECTIVE
  To determine if female gender is an independent predictor of in-hospital mortality after percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI). A higher early mortality rate after STEMI has been reported in women before the widespread use of PCI in STEMI. PCI improves the prognosis of STEMI, however, the effect of PCI in women in this setting is controversial. In a large regional prospective registry, we examined the in-hospital mortality after PCI for STEMI.
  
  
  RESULTS
  The greater Paris area comprises 11 million inhabitants. Data from all PCIs performed in 41 centres is entered in a mandatory registry. In-hospital mortality is recorded in another hospital-based database. From 2003 to 2007, 16,760 patients were treated by PCI for STEMI <24 hours; 21.9% were women. Female patients were significantly older than men, 69.7 ± 14.3 years versus 59.3 ± 13.0 years (p<0.0001). The rate of diabetes mellitus and cardiogenic shock were significantly higher in women versus men, respectively 19.0% versus 15.6%, p<0.0001 and 6.7% versus 4.0%, p<0.0001. The success rate of PCI was significantly lower in women: 94.7% versus 95.9%, p=0.002. In-hospital mortality was significantly higher in women 9.8 % versus 4.3%, p<0.0001 and the impact of gender on mortality was significant only after the age of 75. By multivariate analysis, female gender is associated with higher in-hospital mortality.
  
  
  CONCLUSIONS
  After PCI for STEMI, female gender is still an independent predictor of in-hospital mortality.
authors.affiliation: European Hospital of Paris La Roseraie, Aubervilliers, France. h.benamer@icps.com.fr
authors.forename: Hakim
authors.initials: H
authors.lastname: Benamer
authors.forename: Muriel
authors.initials: M
authors.lastname: Tafflet
authors.forename: Sophie
authors.initials: S
authors.lastname: Bataille
authors.forename: Sylvie
authors.initials: S
authors.lastname: Escolano
authors.forename: Bernard
authors.initials: B
authors.lastname: Livarek
authors.forename: Vincent
authors.initials: V
authors.lastname: Fourchard
authors.forename: Christophe
authors.initials: C
authors.lastname: Caussin
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Teiger
authors.forename: Philippe
authors.initials: P
authors.lastname: Garot
authors.forename: Yves
authors.initials: Y
authors.lastname: Lambert
authors.forename: Xavier
authors.initials: X
authors.lastname: Jouven
authors.forename: Christian
authors.initials: C
authors.lastname: Spaulding
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; D054624:Health Status Disparities; D054625:Healthcare Disparities; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D016017:Odds Ratio; D010297:Paris / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D015912:Thrombolytic Therapy / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents