title: [Primary angioplasty in women: Data from the Portuguese Registry of Interventional Cardiology].
abstract: OBJECTIVE
  Although mortality after primary percutaneous coronary intervention (PPCI) is higher in women than in men, there is disagreement as to whether gender is an independent risk factor for mortality in ST- elevation myocardial infarction (STEMI). Our aim was to assess how gender influenced short-term prognosis in patients undergoing PPCI in the Portuguese Registry of Interventional Cardiology.
  
  
  METHODS
  Of 60 158 patients prospectively included in a large registry of contemporary PCI, from 2002 to 2012, we included 7544 patients with STEMI treated by PPCI, of whom 1856 (25%) were female. The effect of gender on in-hospital mortality was assessed by multivariate logistic regression analysis with propensity score matching.
  
  
  RESULTS
  Women were older (68±14 vs. 61±13 years, p<0.001), with a higher prevalence of diabetes (30% vs. 21%, p<0.001) and hypertension (69% vs. 55%, p<0.001). Men were more frequently revascularized within six hours of symptom onset (71% vs. 63%, p<0.001). Cardiogenic shock was more frequent in women (7.1% vs. 5.7%, p=0.032). Female gender was associated with a worse short-term prognosis, with 1.7 times higher risk of in-hospital death (4.3% in women and 2.5% in men, 95% confidence interval (CI) 1.30-2.27, p<0.001). After computed propensity score matching based on baseline clinical characteristics, in-hospital mortality was similar between women and men (odds ratio 1.00, 95% CI 0.68-1.48, p=1.00).
  
  
  CONCLUSIONS
  In the Registry, women with STEMI treated by PPCI had a greater risk-factor burden, less timely access to treatment and a worse prognosis. However, after risk adjustment, female gender ceases to be an independent predictor of in-hospital mortality.
authors.affiliation: Unidade de Cardiologia de Intervenção, Hospital Garcia de Orta, Almada, Portugal. Electronic address: ritacale@hotmail.com.
authors.forename: Rita
authors.initials: R
authors.lastname: Calé
authors.affiliation: Unidade de Cardiologia de Intervenção, Centro hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: Lídia
authors.initials: L
authors.lastname: de Sousa
authors.affiliation: Unidade de Cardiologia de Intervenção, Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Hélder
authors.initials: H
authors.lastname: Pereira
authors.affiliation: Unidade de Cardiologia de Intervenção, Centro hospitalar de Coimbra, Coimbra, Portugal.
authors.forename: Marco
authors.initials: M
authors.lastname: Costa
authors.affiliation: Unidade de Cardiologia de Intervenção, Hospital de Santa Cruz, C.H.L.O., Carnaxide, Portugal.
authors.forename: Manuel
authors.initials: M
authors.lastname: de Sousa Almeida
mesh_terms: D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011174:Portugal; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors
keywords: Angioplastia primária; Enfarte agudo do miocárdio com supradesnivelamento de ST; Female; Primary angioplasty; ST‐elevation myocardial infarction; Sexo feminino