title: Effect of invasive strategy on different genders of Chinese patients with non-ST-elevation myocardial infarction.
abstract: OBJECTIVE
  The aim of this study was to determine the impact of in-hospital revascularization on different genders and to compare the gender difference in short- and long-term prognosis of Chinese patients with non-ST-elevation myocardial infarction (NSTEMI).
  
  
  BACKGROUND
  The benefit of invasive strategy between the genders of Asian ethnic populations with NSTEMI remains unclear.
  
  
  METHODS
  A total of 343 consecutive NSTEMI patients were enrolled, 104 (30%) of them were women. All patients were followed up for at least 3 years or until the occurrence of a major event. The primary end point was all-cause death. The secondary end point was the combined occurrence of death or myocardial (re-)infarction (MI).
  
  
  RESULTS
  The adjusted in-hospital and long-term clinical outcomes were similar between men and women. However, in-hospital revascularization significantly reduced long-term mortality and composite endpoint in men (P < 0.001), but not in women. After risk stratification by GRACE score, there was favorable effect of invasive strategy in high-risk women. In a multivariate Cox regression analysis, GRACE score (hazard ratio; HR, 1.017; P < 0.001) and in-hospital revascularization (HR, 0.516; P = 0.008) were the independent predictors of death or MI in men. However, only GRACE score was the independent predictor of composite endpoint in women (HR, 1.012; P = 0.004).
  
  
  CONCLUSIONS
  In Asian ethnic patients with NSTEMI, the in-hospital and long-term prognosis were similar between men and women. In-hospital revascularization has a benefit in men and high-risk women for reducing the all-cause death at 1 and 3 years. Our data provide evidence supporting the guideline recommendation for an invasive strategy in high-risk women.
authors: Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Shao-Sung
authors: SS
authors: Huang
authors: Ying-Hwa
authors: YH
authors: Chen
authors: Tse-Min
authors: TM
authors: Lu
authors: Tao-Cheng
authors: TC
authors: Wu
authors: Min-Ji
authors: MJ
authors: Charng
authors: Jaw-Wen
authors: JW
authors: Chen
authors: Ju-Pin
authors: JP
authors: Pan
authors: Shing-Jong
authors: SJ
authors: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D044466:Asian People / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D016017:Odds Ratio; D018579:Patient Selection; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome