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Gender-related differences in outcome after ST-segment elevation myocardial infarction treated by primary angioplasty and glycoprotein IIb–IIIa inhibitors: insights from the EGYPT cooperation

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Abstract

Several studies have found that among patients with ST-elevation myocardial infarction (STEMI) treated by thrombolysis, female sex is associated with a worse outcome. The aim of this study was to investigate sex-related differences in clinical and angiographic findings in patients with STEMI treated with primary angioplasty and Gp IIb–IIIa inhibitors. Our population is represented by 1662 patients undergoing primary angioplasty included in the EGYPT database. Myocardial perfusion was evaluated by myocardial blush grade and ST-segment resolution. Follow-up data were collected between 30 days and 1 year after primary angioplasty. Among 1662 patients, 379 were women (22.8%). Female sex was associated with more advanced age, higher prevalence of diabetes, hypertension, more advanced Killip class, longer ischemia time, less often smokers, with higher prevalence of preprocedural recenalization. No difference was observed in terms of postprocedural TIMI flow, myocardial perfusion and distal embolization. Similar findings were observed in terms of enzymatic infarct size and preprocedural ejection fraction. Female gender was associated with higher mortality (6.4% vs. 3.6%, HR = 1.83 [1.12–3.0], P = 0.015). However, the difference disappeared after correction for baseline confounding factors (HR = 1.01 [0.56–1.83], P = 0.98). This study shows that in patients with STEMI treated by primary angioplasty, female gender is associated with higher mortality rate in comparison with men, and this is mainly due to their higher clinical and angiographic risk profiles. In fact, female sex did not emerge as an independent predictor of mortality.

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Authors and Affiliations

  1. Division of Cardiology, Maggiore della Carità Hospital, Eastern Piedmont University, Novara, Italy

    Giuseppe De Luca

  2. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA

    C. Michael Gibson

  3. Department of Cardiology, Medical University of Vienna, Vienna, Austria

    Mariann Gyöngyösi

  4. Division of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany

    Uwe Zeymer

  5. II Department of Cardiology, Institute of Cardiology, Jagiellonian University, Krakow, Poland

    Dariusz Dudek & Tomasz Rakowski

  6. Medizinische Klinik II, Kardiologie/Pulmologie, Charité, Campus Benjamin Franklin, Berlin, Germany

    Hans-Richard Arntz

  7. Division of Cardiology, Prato Hospital, Prato, Italy

    Francesco Bellandi & Mauro Maioli

  8. Center For Intensive Internal Medicine, University Medical Center, Ljubljana, Slovenia

    Marko Noc & Simona Zorman

  9. Division of Cardiology, Hospital de Santa Maria, Lisbon, Portugal

    H. Mesquita Gabriel

  10. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Instabul, Turkey

    Ayse Emre

  11. Interventional Cardiology Section, Beth Israel Deaconess Medical Center, Boston, Massachusets, USA

    Donald Cutlip

  12. 3rd Department of Medicine (Cardiology and Emergency Medicine), Wilhelminen Hospital, Vienna, Austria

    Kurt Huber

  13. Division of Cardiology, Hospital “De Weezenlanden”, Zwolle, Netherlands

    Arnoud W. J. van’t Hof

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  1. Giuseppe De Luca
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  2. C. Michael Gibson
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  3. Mariann Gyöngyösi
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  4. Uwe Zeymer
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  5. Dariusz Dudek
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  7. Francesco Bellandi
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  8. Mauro Maioli
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  9. Marko Noc
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  10. Simona Zorman
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  11. H. Mesquita Gabriel
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  12. Ayse Emre
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  13. Donald Cutlip
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  14. Tomasz Rakowski
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  15. Kurt Huber
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  16. Arnoud W. J. van’t Hof
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Correspondence to Giuseppe De Luca.

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De Luca, G., Gibson, C.M., Gyöngyösi, M. et al. Gender-related differences in outcome after ST-segment elevation myocardial infarction treated by primary angioplasty and glycoprotein IIb–IIIa inhibitors: insights from the EGYPT cooperation. J Thromb Thrombolysis 30, 342–346 (2010). https://doi.org/10.1007/s11239-010-0451-y

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