title: [Therapeutic approach and mortality in men and women with ST-segment elevation myocardial infarction].
abstract: The benefit of immediate reperfusion in the treatment of ST-segment elevation myocardial infarction (STEMI) is indisputable. Unfortunately, no reperfusion therapy is applied to nearly 30% of patients without contraindication to such treatment. We aimed to analyze the impact of therapeutic approach on the prognosis after acute phase of STEMI.
  
  
  METHODS
  The study group consisted of 26035 consecutive STEMI patients (8989 females, 34.4%) hopitalized in 456 sites during one year. Data were available from the Polish Registry of Acute Coronary Syndromes (PL-ACS) launched in Silesian Center for Heart Diseases, Zabrze.
  
  
  RESULTS
  Patiens treated with primary percutaneous intervention (pPCI) had the best outcome. All therapeutic strategies resulted in worse prognosis in women when compared to men. Women had greater 12-month mortality in the conservative, fibrinolytic and interventional treatment group: 33.1% vs 23.2%; p < 0.0001; 24.3% vs 16.2%; p < 0.0001 i 11.4% vs 8.2%, p < 0.0001, respectively. Differences in the surgically treated group were insignificant (men: 25%, women: 8%, p = 0.42).
  
  
  CONCLUSIONS
  The outcome of conservative, fibrinolytic and interventional treatment was worse in the female group. Primary coronary angioplasty was the most benefical therapeutic strategy.
authors.forename: Marcin
authors.initials: M
authors.lastname: Sadowski
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Janion-Sadowska
authors.forename: Gierlotka
authors.initials: G
authors.lastname: Marek
authors.forename: Lech
authors.initials: L
authors.lastname: Poloński
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D015425:Myocardial Reperfusion; D011379:Prognosis; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents