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Sex Differences in Myocardial Salvage and Clinical Outcome in Patients with Acute Reperfused ST-Elevation Myocardial Infarction.
MedLine Citation:
PMID:  22028459     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -There is conflicting evidence regarding sex-based differences in myocardial salvage and clinical outcome in patients after ST-elevation myocardial infarction (STEMI). The aim of this study was to investigate whether there are gender-associated differences in infarct characteristics (myocardial salvage, infarct size, microvascular obstruction) and clinical outcome in STEMI patients reperfused by primary angioplasty. METHODS AND RESULTS: -In this study we included 96 women and 239 men with STEMI undergoing primary angioplasty <12 hours after symptom-onset. T2-weighted and contrast-enhanced cardiac magnetic resonance imaging was used to assess myocardial salvage, infarct size and microvascular obstruction. The primary clinical endpoint was mortality within 6 months after the index event. The amount of myocardium at risk and final infarct size did not differ significantly between women and men. Consequently, myocardial salvage was similar between groups (p=0.36). Women had a higher in-hospital (3% versus 10%, p=0.03) and 30-day (5% versus 11%, p=0.05) mortality rate than men. Six months after infarction, no significant sex differences in survival were obvious (11% versus 7%, p=0.21). After adjustment for baseline differences (age, diabetes, hypertension) female gender was no independent predictor of mortality and major adverse cardiac events. CONCLUSIONS: -The efficacy of primary PCI (myocardial salvage) in patients with STEMI is not gender-dependent. Although female STEMI patients had worse unadjusted in-hospital and 30-day clinical outcomes than men, multivariable analysis revealed that the observed sex-based differences in early death after STEMI were likely related to differences in baseline risk and clinical characteristics.
Authors:
Ingo Eitel; Steffen Desch; Suzanne de Waha; Georg Fuernau; Matthias Gutberlet; Gerhard Schuler; Holger Thiele
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-25
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University of Leipzig, Heart Center, Leipzig, Germany.
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