title: Is female gender associated with worse outcome after ST elevation myocardial infarction?
abstract: OBJECTIVE
  To investigate the impact of gender in outcomes of patients with ST segment myocardial infarction in a setting with limited access to primary percutaneous coronary intervention METHODS: In 1017 consecutive patients hospitalized with ST segment myocardial infarction during years 2008-2013, distribution of risk factors, therapeutic methods, heart failure and in-hospital mortality were compared between males and females. Association of gender and primary outcomes was determined after adjustment for confounding factors.
  
  
  RESULTS
  Females were significantly older (66±12.1years vs. 59.5±12.7years, p<0.001). Prevalence of hypertension, hyperlipidemia and diabetes was significantly higher in females (72.2% vs. 39%, p<0.001, 36.1% vs. 20.3%, p<0.001, 46.5% vs. 32.1%, p<0.001, respectively). Presentation delay was similar in males and females. Females received reperfusion therapy more than males (63.2%vs. 55.8%, p=0.032). Development of heart failure and in-hospital mortality were significantly higher in females (36.5% vs. 27.2%, p=0.003 and 19.4% vs. 12.1%, p=0.002, respectively). However in multivariate analysis, female gender was not independently associated with increased rate of heart failure and in-hospital mortality CONCLUSION: In a center with low rate of primary percutaneous coronary intervention, crude rates of heart failure and in-hospital mortality are higher in females; however, the association is lost after adjustment for baseline characteristics.
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Samad
authors.initials: S
authors.lastname: Ghaffari
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Anesthesiology Department, University at Buffalo, Buffalo, NY, United States.
authors.forename: Leili
authors.initials: L
authors.lastname: Pourafkari
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Arezou
authors.initials: A
authors.lastname: Tajlil
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Roza
authors.initials: R
authors.lastname: Bahmani-Oskoui
authors.affiliation: Anesthesiology Department, University at Buffalo, Buffalo, NY, United States. Electronic address: nadernd@gmail.com.
authors.forename: Nader D
authors.initials: ND
authors.lastname: Nader
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Coronary reperfusion; Gender; In-hospital mortality; Myocardial infarction