title: Sex-related analysis of short- and long-term clinical outcomes and bleeding among patients treated with primary percutaneous coronary intervention: an evaluation of the RISK-PCI data.
abstract: BACKGROUND
  Unfavourable effect of female sex on short- and long-term clinical outcomes has been demonstrated in unselected ST-elevation acute myocardial infarction (STEMI) patients; the results are conflicting in patients who undergo primary percutaneous coronary intervention (PPCI). The objective of this substudy was to determine whether there are sex-related differences in the 30-day and 1-year clinical outcomes and bleeding after PPCI for STEMI.
  
  
  METHODS
  We analyzed 2096 STEMI patients enrolled in the Risk Scoring Model to Predict Net Adverse Cardiovascular Outcomes After Primary Percutaneous Coronary Intervention (RISK-PCI) trial from February 2006 to December 2009. Composite efficacy end point comprised all-cause mortality, nonfatal infarction, and stroke. Safety end point was bleeding classified according to the Thrombolysis in Myocardial Infarction (TIMI) criteria. Net adverse cardiovascular events included composite efficacy end point and total bleeding.
  
  
  RESULTS
  Women in our study were older and presented later than men. After adjustment for potential confounders, there was no difference between sexes with respect to the composite efficacy end point. A higher rate of total bleeding was observed in women (adjusted odds ratio [OR], 1.67; 95% confidence interval [CI], 1.07-2.61 at 30 days, adjusted OR, 1.63; 95% CI, 1.08-2.47 at 1 year) compared with men. Total bleeding was associated with increased mortality at 30 days (OR, 4.87; 95% CI, 2.79-8.47) and at 1 year (OR, 4.43; 95% CI, 2.79-7.02) after PPCI.
  
  
  CONCLUSIONS
  We did not find a significant sex-related difference with respect to the composite efficacy end point. Women had a higher rate of total bleeding which was associated with increased short- and long-term mortality. Specific measures aimed at preventing bleeding in women might improve the prognosis of PPCI patients.
authors: School of Medicine, University of Belgrade, Belgrade, Serbia. igormrd@gmail.com
authors: Igor
authors: I
authors: Mrdovic
authors: Lidija
authors: L
authors: Savic
authors: Milika
authors: M
authors: Asanin
authors: Natasa
authors: N
authors: Cvetinovic
authors: Natasa
authors: N
authors: Brdar
authors: Nemanja
authors: N
authors: Djuricic
authors: Milena
authors: M
authors: Stepkovic
authors: Jelena
authors: J
authors: Marinkovic
authors: Jovan
authors: J
authors: Perunicic
mesh_terms: D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D011379:Prognosis; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome