Resultados hospitalares da intervenção coronária percutânea primária em mulheres

Abstract

In-Hospital Outcomes of Primary Percutaneous Coronary Intervention in WomenBackground: Women with acute myocardial infarction (AMI) have higher mortality rates than men. Primary percutaneous coronary intervention (PCI) plays a major role in reducing AMI mortality rates. We tried to identify whether there are differences in in-hospital outcomes of primary PCI between women and men. Methods: From January 2002 and October 2008, 428 primary PCIs were performed, 125 (29.2%) in female patients. The technique and device selection were at the operator's discretion. All of the patients received dual antiplatelet therapy before the procedure. Results: Female patients were older (65.1 years vs. 59.2 years; P < 0.001), and more frequently presented Killip III/IV (11.2% vs. 3.3%; P = 0.002). Stent diameter was smaller in women (3.1 + 0.4 mm vs. 3.3 + 0.5 mm; P < 0.001), but there were no differences in stent length (19.1 + 6.5 mm vs. 18.7 + 6.2 mm; P = 0.55), door-to-balloon time (159.4 + 110.1 minutes vs. 138.9 + 138.3 minutes; P = 0.19), use of glycoprotein IIb/IIIa inhibitors (32% vs. 31%; P = 0.58) or thrombus aspiration catheters (10.4% vs. 9.9%; P = 0.65). Procedure success was similar (97.1% vs. 96.7%) and women had a higher likelihood of death (5.6% vs. 2%; P = 0.06) and stroke (0.8% vs. 0.3%; P = 0.09). Major vascular complications (6.4% vs. 5.6%; P = 0.49) were similar in both genders. Conclusions: In this study women represent a third of the patients undergoing primary PCI, have a more complex clinical-angiographic profile and tend to evolve with a higher probability of major adverse cardiovascular events.