title: Gender-related differences in patients with ST-elevation myocardial infarction: results from the registry study of the ST elevation myocardial infarction network Essen.
abstract: BACKGROUND
  The Myocardial Infarction Network Essen was initiated in order to establish a standardized procedure with immediate reopening of the infarcted vessel for patients with ST-elevation myocardial infarction (STEMI) in the city of Essen, Germany. The present study aims to evaluate gender-related differences in presentation of disease and clinical outcome.
  
  
  OBJECTIVE
  Gender is associated with differences in presentation and outcome of STEMI.
  
  
  METHODS
  All patients with STEMI were included without exception. Parameters such as risk profile, mortality, and relevant time intervals were documented. The follow-up period was 1 year.
  
  
  RESULTS
  For this study, 1365 patients (72.1% male) were recruited. Women were significantly older, with higher prevalence of diabetes (28.1% vs 20.3%, P = 0.004) and hypertension (76.5% vs 64.8%, P<0.0005). Analysis of time intervals between symptoms to actions showed no significant differences. However, women tended to wait longer before calling for medical assistance (358 vs 331 min, P = 0.091). In-hospital mortality was comparable with respect to gender, whereas women had higher 1-year mortality (18.6% vs 13.2%). Age and diabetes were associated with a higher mortality. Adjusted for age, gender is no longer an independent risk factor. In the follow-up period, significantly more women were readmitted to the hospital without a difference in the frequency of reangiography, surgery, or target-vessel revascularization.
  
  
  CONCLUSIONS
  The present data display a successful implementation of a standardized procedure in patients with STEMI. Although differences between genders are not as obvious as expected, efforts should be taken to perform a gender-specific risk analysis as well as to promote education about proper behavior in case of new onset of angina.
authors.affiliation: Department of Cardiology, Catholic Clinics Essen-Northwest, Essen, Germany. b.hailer@kkenw.de
authors.forename: Birgit
authors.initials: B
authors.lastname: Hailer
authors.forename: Christoph
authors.initials: C
authors.lastname: Naber
authors.forename: Bernd
authors.initials: B
authors.lastname: Koslowski
authors.forename: Peter
authors.initials: P
authors.lastname: van Leeuwen
authors.forename: Harald
authors.initials: H
authors.lastname: Schäfer
authors.forename: Thomas
authors.initials: T
authors.lastname: Budde
authors.forename: Rainer
authors.initials: R
authors.lastname: Jacksch
authors.forename: Georg
authors.initials: G
authors.lastname: Sabin
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D005783:Gender Identity; D005858:Germany / Q000453:epidemiology; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D012042:Registries; D018570:Risk Assessment; D012737:Sex Factors; D013223:Statistics as Topic; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left