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11-12-2011 | Cardiology | Article

Efficacy of primary PCI ‘equivalent’ in men and women

Abstract

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MedWire News: Women have higher unadjusted in-hospital and 30-day mortality rates following primary percutaneous coronary intervention (PCI) when compared with men, research shows.

However, multivariable analysis suggests the difference in mortality is "likely related to differences in baseline risk and clinical characteristics," report Ingo Eitel (University of Leipzig, Germany) and colleagues in the journal Circulation: Cardiovascular Imaging.

Numerous studies have investigated the gender-based differences in outcomes following myocardial infarction (MI), say Eitel et al. Some have shown higher rates of mortality following ST-segment elevation myocardial infarction (STEMI), but others have shown no relationship between gender and clinical outcomes.

In this study, involving STEMI patients undergoing primary PCI less than 12 hours after symptom onset, Eitel and colleagues assessed infarct characteristics of 96 women and 239 men, in addition to early and late mortality rates.

Myocardium risk and infarct size did not significantly differ between the men and women. As a result, there were no significant differences in myocardial salvage between the groups.

Based on this finding, Eitel and colleagues concluded that the efficacy of primary PCI in patients with STEMI is not dependent on gender.

In-hospital mortality rates were 10% in women and 3% in men, giving a significant hazard ratio [HR] of 2.81. At 30 days, mortality was 11% in women and 5% in men, giving a significant HR of 6.21.

After adjusting for multiple clinical characteristics, however, gender was not a significant predictor of in-hospital mortality or 30-day mortality, report Eitel and colleagues.

At 6 months, no significant gender-based differences in mortality were evident, they add.

The women in this analysis, consistent with previous studies, had a higher baseline risk profile compared with men; they tended to be older, had more hypertension and diabetes, and had longer delays between symptom onset and PCI.

The delayed reperfusion times among women "highlights the need to improve the awareness of risk for ischemic heart disease and provision of healthcare among women," state the researchers.

By MedWire Reporters

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