title: A meta-analysis of sex-related differences in outcomes after primary percutaneous intervention for ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  The increasing use of primary percutaneous coronary intervention (pPCI) has improved clinical outcome in ST-segment elevation myocardial infarction (STEMI) patients, but the impact of sex on early and mid-term outcomes remains to be defined.
  
  
  METHODS
  Medline, Cochrane Library, Biomed Central, and Google Scholar were searched for articles describing differences in baseline, periprocedural, and midterm outcomes after pPCI, by sex. The primary end point was all-cause mortality at early and mid-term follow-up. Secondary endpoints included in-hospital bleeding and stroke.
  
  
  RESULTS
  Sixteen studies were included. Women were older, had more frequent hypertension, diabetes mellitus, and hypercholesterolemia, as well as longer ischemia time and more shock at presentation. Men were more likely to have had a previous myocardial infarction. Female sex emerged as independently associated to early mortality (OR 1.1; 95%CI, 1.02-1.18) but not to mid-term mortality (OR, 1.01; 95%CI, 0.99-1.03). The pooled analysis showed a significantly higher risk of in hospital stroke (OR, 1.69; 95%CI, 1.11-2.56) and major bleeding (OR, 2.04; 95%CI, 1.51-2.77) in women.
  
  
  CONCLUSIONS
  As compared to men, women undergoing pPCI have more bleedings and strokes, and a worse early, but not mid-term mortality. These findings may allow a better risk stratification of pPCI patients.
authors.affiliation: Department of Cardiology, Città, Della Salute e della Scienza Hospital, Turin, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Conrotto
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.forename: Karin H
authors.initials: KH
authors.lastname: Humphries
authors.forename: John G
authors.initials: JG
authors.lastname: Webb
authors.forename: Paolo
authors.initials: P
authors.lastname: Scacciatella
authors.forename: Costanza
authors.initials: C
authors.lastname: Grasso
authors.forename: Maurizio
authors.initials: M
authors.lastname: D'Amico
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Marra
mesh_terms: D005260:Female; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology; D016896:Treatment Outcome