Document Detail


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.
MedLine Citation:
PMID:  20213259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Giuseppe De Luca; C Michael Gibson; Mariann Gyöngyösi; Uwe Zeymer; Dariusz Dudek; Hans-Richard Arntz; Francesco Bellandi; Mauro Maioli; Marko Noc; Simona Zorman; H Mesquita Gabriel; Ayse Emre; Donald Cutlip; Tomasz Rakowski; Kurt Huber; Arnoud W J van't Hof
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  30     ISSN:  1573-742X     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-24     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  342-6     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Maggiore della Carità Hospital, Eastern Piedmont University, Novara, Italy. giuseppe.deluca@maggioreosp.novara.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty* / adverse effects,  mortality
Female
Humans
Male
Middle Aged
Mortality
Myocardial Infarction / complications,  epidemiology*,  etiology,  mortality,  therapy*
Platelet Aggregation Inhibitors / therapeutic use
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Risk Factors
Sex Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex

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


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