Author + information
- Ivana Borges,
- Edison Peixoto,
- Rodrigo Peixoto,
- Ricardo Peixoto,
- Alexandre Aragao and
- Vanessa Marcolla
Coronary heart disease is the leading cause of mortality and morbidity. A higher mortality risk for women with acute ST-elevation myocardial infarction has been a common finding in the past, even after acute percutaneous transluminal coronary angioplasty (PTCA). Prior studies have reported worse results after PTCA in women than in men. However, recent data suggest that this difference is less marked.
To determine gender-related differences and risk factors for death and major events, both in-hospital and at six-month follow-up, of patients that have been admitted within the first twelve hours of ST-segment elevation acute myocardial infarction (AMI) and primary PTCA in other to set out whether there are gender differences in a real-world comtemporary treatment and outcome.
For two consecutive years, 199 consecutive patients were enrolled in the study, with ST-segment elevation AMI and primary PTCA without cardiogenic shock. The immediate outcome, in-hospital and six-month follow-up were studied. Multivariate Cox analysis were performed to identify independent predictors of death and major events.
Clinical characteristics were similar in both groups, except that women were older than men (67.04 +/- 11.53 x 59.70 +/- 10.88, p < 0.0001). In-hospital mortality was higher among women (9.1% x 1.5%, p = 0.0171), as was the incidence of major events (12.1% x 3.0%, p = 0.0026). The difference in mortality rates remained the same at six months (12.1% x 1.5%, p = 0.0026). The independente predictors of death in multivariate analysis: were: female gender and age >80 years old. Independent predictors of major events and/or angina were: multivessel disease and severe ventricular dysfunction.
After ST-segment elevation AMI and primary PTCA, the independent predictors of mortality throughout the follow-up were female gender and age >80 years, in both in-hospital and six months follow-up.