Author + information
Historically, studies have reported that women with ST segment elevation myocardial infarction (STEMI) have worse outcomes than men. However whether these gender differences persist among patients over 75 years of age remains unclear as this population has been underrepresented in clinical trials.
Using the national inpatient sample from 2007-2013, 35,637 patients over 75 years of age undergoing percutaneous coronary intervention (PCI) for STEMI were identifying. Using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) codes, patients were identified. Baseline characteristics, procedural details and in-hospital outcomes were compared between gender groups. Analysis was performed using SAS 9.4 (SAS Institute Inc, Cary, North Carolina). Patients with missing data on gender, in-hospital outcomes and age were excluded.
Elderly women presented with higher age, preexisting conditions and more anterior wall MI and demonstrated significantly higher in-hospital mortality and secondary outcomes; i.e., acute renal failure, cardiogenic shock, stroke, gastrointestinal hemorrhage and blood loss requiring transfusion (p<0.001).
Gender difference in STEMI care have been previously described. Among patients undergoing primary PCI for STEMI, elderly women demonstrate higher in hospital mortality with overall worse outcomes as compared to men. These differences in this older cohort of patients reveals that more effort needs to be made to understand why women fare worse than men.