Document Detail

Gender disparity in 48-hour mortality is limited to emergency percutaneous coronary intervention for ST-elevation myocardial infarction.
MedLine Citation:
PMID:  20619239     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Previous studies indicate that mortality from acute coronary syndromes is higher in women than in men, especially in case of interventional strategy.
AIM: To assess whether the in-hospital mortality rate differs between genders during the first 48h after emergency percutaneous coronary intervention for ST-elevation myocardial infarction (emergency PCI-STEMI) or after non-emergency PCI.
METHODS: All patients treated with PCI between January 2005 and June 2008 were included. The primary endpoint was frequency of death within 48h after the PCI procedure; secondary endpoints included frequency of recurrent myocardial infarction, new PCI or coronary artery bypass graft surgery, stroke, and major vascular or renal complications. Data were analysed via logistic regression with and without propensity-score matching.
RESULTS: More than 9000 patients underwent PCI. In the emergency PCI-STEMI group (n=1753), 48-hour mortality occurred in 2.2% of men and 4.9% of women (p=0.004). However, gender disparity occurred only in elderly patients; the rate was significantly (p=0.02) higher in women (8.1%) than in men (3.3%) aged > or =75 years. There was no evidence of gender disparity in the non-emergency PCI group (n=7336) or in secondary endpoints for either PCI group. Similar results were obtained in pair analyses of men and women with matching propensity scores.
CONCLUSIONS: Elderly women have a disproportionately high in-hospital mortality rate during the first 48h after emergency PCI for treatment of STEMI; however, there is no gender discrepancy in younger patients or patients of any age who receive non-emergency procedures.
Jérôme Roncalli; Meyer Elbaz; Nicolas Dumonteil; Nicolas Boudou; Olivier Lairez; Thibault Lhermusier; Talia Chilon; Cécile Baixas; Michel Galinier; Jacques Puel; Jean-Marie Fauvel; Didier Carrié; Jean-Bernard Ruidavets
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-06-04
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  103     ISSN:  1875-2128     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-10-15     Revised Date:  2011-04-25    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  293-301     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Masson SAS. All rights reserved.
Department of Cardiology, Rangueil University Hospital, Toulouse, France.
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MeSH Terms
Age Factors
Aged, 80 and over
Angioplasty, Balloon, Coronary / adverse effects,  mortality*
Cardiology Service, Hospital / statistics & numerical data*
Chi-Square Distribution
Emergency Service, Hospital / statistics & numerical data*
France / epidemiology
Health Status Disparities*
Hospital Mortality
Logistic Models
Middle Aged
Myocardial Infarction / mortality*,  therapy*
Odds Ratio
Propensity Score
Risk Assessment
Risk Factors
Sex Factors
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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