Sex-related differences after contemporary primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.
BACKGROUND
Whether outcomes differ for women and men after percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) remains controversial.


OBJECTIVE
To compare 1-year outcomes after primary PCI in women and men with STEMI, matched for age and diabetes.


METHODS
Consecutive women with STEMI of<24 hours' duration referred (August 2007 to January 2011) for primary PCI were compared with men matched for age and diabetes. Rates of all-cause mortality, target vessel revascularization (TVR) and major cardiovascular and cerebrovascular events (MACCE) (death/myocardial infarction/stroke) were assessed at 1 year.


RESULTS
Among 775 consecutive patients, 182 (23.5%) women were compared with 182 matched men. Mean age was 69±15 years, 18% had diabetes. Patient characteristics were similar, except for lower creatinine clearance (73±41 vs 82±38 μmol/L; P=0.041), more cardiogenic shock (14.8% vs 6.6%; P=0.017) and less radial PCI (81.3% vs 90.1%; P=0.024) in women. Rates of 1-year death (22.7% vs 18.1%), TVR (8.3% vs 6.0%) and MACCE (24.3% vs 20.9%) were not statistically different in women (P>0.05 for all). After exclusion of patients with shock (10.7%) and out-of-hospital cardiac arrest (6.6%), death rates were even more similar (11.3% vs 11.8%; P=0.10). Female sex was not independently associated with death (odds ratio 1.01, 95% confidence interval 0.55-1.87; P=0.97).


CONCLUSIONS
In our consecutive unselected patient population, women had similar 1-year outcomes to men matched for age and diabetes, after contemporary primary PCI for STEMI, despite having a higher risk profile at baseline.
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France. Electronic address: olivier.barthelemy@psl.aphp.fr.
Olivier
O
Barthélémy
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Philippe
P
Degrell
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Emmanuel
E
Berman
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Mathieu
M
Kerneis
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Thibaut
T
Petroni
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Johanne
J
Silvain
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Laurent
L
Payot
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Remi
R
Choussat
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Jean-Philippe
JP
Collet
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Gerard
G
Helft
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Gilles
G
Montalescot
Institut de cardiologie (AP-HP), université Paris 6, Pitié-Salpêtrière Hospital, Paris, France.
Claude
C
Le Feuvre
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005602:France; D054624:Health Status Disparities; D017052:Hospital Mortality; D061847:Hospitals, High-Volume; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
Angioplastie coronaire; Coronary angioplasty; Femme; Infarctus du myocarde; Myocardial infarction; Sex; Sexe; Women