title: Sex-based differences in clinical practice and outcomes for Japanese patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: BACKGROUND
  Limited data are available for sex-based differences in Japanese patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI).
  
  
  RESULTS
  The study patients comprised 1,197 women and 3,182 men who underwent primary PCI for AMI in 2005-2007. Compared with the men, the women were significantly older, and had significantly longer onset-to-balloon time and lower rate of follow-up coronary angiography. In-hospital mortality was higher among women than men (8.7% vs. 4.9%, P<0.001). Although the cumulative incidence of all-cause death at 3 years was also higher for women (17.7% vs. 10.7%, P<0.001), the adjusted risk for all-cause death was comparable [hazard ratio (HR, women vs. men)=0.94, 95% confidence interval (CI): 0.71-1.24, P=0.66]. The incidence (12.1% vs. 12.4%, P=0.77) and the adjusted risk (HR=0.99, 95% CI 0.78-1.24, P=0.92) for any clinically-driven coronary revascularization were both comparable. However, regarding any non-clinically-driven coronary revascularization, the incidence (19.6% vs. 27.8%, P<0.001) and the adjusted risk (HR=0.79, 95% CI 0.65-0.95, P=0.012) were both lower in women relative to men.
  
  
  CONCLUSIONS
  In current Japanese clinical practice for AMI, onset-to-balloon time was significantly longer in women than in men. Female sex was associated with lower follow-up coronary angiography rate and lower incidence of any non-clinically-driven coronary revascularization, whereas the incidence of any clinically-driven coronary revascularization was comparable between the sexes.
authors: Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors: Toshiaki
authors: T
authors: Toyota
authors: Yutaka
authors: Y
authors: Furukawa
authors: Natsuhiko
authors: N
authors: Ehara
authors: Shunsuke
authors: S
authors: Funakoshi
authors: Takeshi
authors: T
authors: Morimoto
authors: Shuichiro
authors: S
authors: Kaji
authors: Yoshihisa
authors: Y
authors: Nakagawa
authors: Kazushige
authors: K
authors: Kadota
authors: Masashi
authors: M
authors: Iwabuchi
authors: Hiroki
authors: H
authors: Shiomi
authors: Atsushi
authors: A
authors: Yamamuro
authors: Makoto
authors: M
authors: Kinoshita
authors: Takeshi
authors: T
authors: Kitai
authors: Kitae
authors: K
authors: Kim
authors: Tomoko
authors: T
authors: Tani
authors: Atsushi
authors: A
authors: Kobori
authors: Toru
authors: T
authors: Kita
authors: Ryuzo
authors: R
authors: Sakata
authors: Takeshi
authors: T
authors: Kimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D017023:Coronary Angiography; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D012727:Sex Characteristics; D012737:Sex Factors; D015996:Survival Rate; D013997:Time Factors