title: [The role of gender difference on the prognosis of ST-segment elevation myocardial infarction (STEMI) in patients treated with primary percutaneous coronary intervention].
abstract: OBJECTIVE
  To investigate and analyze the impact of gender difference on outcome and prognosis of ST-segment elevation myocardial infarction (STEMI) in patients treated with primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  This was a prospective and multicentered observation study. All the patients with acute STEMI admitted to the hospitals from June 1(st) 2009 to June 1(st) 2010 were continuously recruited. In this study, a unified questionnaire was applied and the 382 patients satisfied the criteria. A unified follow-up questionnaire was used on patients who were discharged from the hospital.
  
  
  RESULTS
  On average, the female patients were 8 years older than the males. The median "symptom-to-balloon time" was 312.5 minutes in females and 270.0 minutes in males, and it was significantly different (P = 0.007). During hospitalization, a higher proportion of female patients developed heart failure, angina and bleeding. No gender differences were found on the in-hospital mortality rates and medical therapy recommended by the guideline. The female patients were more prone to multi-vessel disease than males (P = 0.002). Success rates of primary PCI did not show any gender differences. One-month mortality and other cardiovascular events also did not show gender difference when the patients were followed for one month after being discharged. The rates of heart failure and re-hospitalization due to cardiac incidents among female patients were obviously higher than the males, three months after being discharged (P = 0.007, respectively). However, the three-month and long-term cardiac mortality did not show differences related to gender. Female patients were associated with higher all-cause mortality than that in males, but there was no statistically significant difference (female 4.2% vs. male 1.6%; P = 0.056). Data from multi-factor regression analysis showed that being female was not an independent predictor related to in-hospital mortality or during the follow-up period.
  
  
  CONCLUSIONS
  Being female was not an independent predictor of in-hospital mortality or during follow-up period among patients who were treated with primary PCI. Worse long-term outcome seen in female patients was likely to be explained by older age or longer pre-hospital delayed time.
authors.affiliation: Department of Cardiology, First Affiliated Hospital, China Medical University, Shenyang 110001, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Da-ming
authors.initials: DM
authors.lastname: Jiang
authors.forename: Yu-jiao
authors.initials: YJ
authors.lastname: Sun
authors.forename: Li-na
authors.initials: LN
authors.lastname: Ren
authors.forename: Zhi-hong
authors.initials: ZH
authors.lastname: Zhang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Gao
authors.forename: Yu-ze
authors.initials: YZ
authors.lastname: Li
authors.forename: Xu-chen
authors.initials: XC
authors.lastname: Zhou
authors.forename: Guo-xian
authors.initials: GX
authors.lastname: Qi
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors