Controversies in the Treatment of Women with ST-Segment Elevation Myocardial Infarction

Ng, Vivian G.; Lansky, Alexandra J.

doi:10.1016/j.iccl.2016.06.014

Cited by 3 publications

(5 citation statements)

References 112 publications

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“…The findings in our study are consistent with those of Ng and Lansky [ 19 ], Pedersen et al [ 20 ], and, more recently Kanic et al [ 21 ] who also found a correlation between higher age and more frequent comorbidities in women. Females in our study were older than males at the time of diagnosis, which carries a higher risk of comorbidities.…”

Section: Discussionsupporting

confidence: 93%

“…The high incidence of mitral regurgitation that we found in female patients was also documented by other authors [16]. The significant difference in the incidence of heart failure in our study with 41.5% in females as compared to 27% in males is often attributed to structural differences between the genders [17][18][19][20].…”

Section: Discussionsupporting

confidence: 85%

“…In our study, we did not find a statistically significant difference in the mortality between the genders, although females had a higher mortality risk than male patients. As described in previous studies, the women in our study had a higher mean age at the time of presentation than men [18,19]. Heart failure was more frequent in female than in male patients.…”

Section: Discussionsupporting

confidence: 72%

“…Only a few studies have tried to explain the higher mortality in female patients with STEMI as compared to male patients [ 17 - 19 ]. The potential reasons suggested by these authors included a delayed response, differences in the medical attention given to female patients as compared to male patients, or in distinct pathophysiological processes related to the female gender [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Effect of Gender on the Outcomes of ST-Elevation Myocardial Infarction at a Tertiary Care Hospital in Riyadh, Saudi Arabia

Alharbi

Alanazi

Alquhays

et al. 2020

Cureus

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This study aimed to evaluate the impact of gender on the outcomes among ST elevation myocardial infarction patients at King Abdulaziz Medical City in Riyadh, Saudi Arabia. Methods This retrospective study analyzed the data of 900 patients (770 males and 130 females) admitted between January 2016 and December 2018 diagnosed with ST-elevation myocardial infarction (STEMI). We recorded the baseline characteristics, comorbidities, treatment, complications, and mortality for all patients, and compared these data between female and male patients. Results The baseline characteristics: BMI and age were higher in females and were statistically significant (p = 0.0001). We found a higher incidence of heart failure in females than in males which was statistically significant (p = 0.0010). In addition, the mortality rate was higher in female than in male patients, although this difference was not statistically significant (p = 0.3850). Conclusion In conclusion, despite the advances in the technology and the use of novel reperfusion therapies females were associated with poorer outcomes after adjustment of the baseline characteristics and risk factors. In other words, heart failure, mitral regurgitation, and arrhythmias were higher in females with significant p values.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of Gender on the Outcomes of ST-Elevation Myocardial Infarction at a Tertiary Care Hospital in Riyadh, Saudi Arabia

Alharbi

Alanazi

Alquhays

et al. 2020

Cureus

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“…Several studies have reported a high prevalence of in-hospital complications and death in women presenting with ST-elevation Myocardial Infarction (STEMI) despite the marked improvements in revascularization strategies and secondary prevention [ 5 – 7 ]. Data from developed countries have shown that women with STEMI tend to have worse in-hospital outcomes, such as acute heart failure and higher in-hospital mortality than men regardless of the revascularization strategies (fibrinolysis or primary percutaneous coronary intervention (pPCI)) [ 8 – 11 ]. On the other hand, women with STEMI receive reperfusion therapy less frequently compared to men [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

ST-segment elevation myocardial infarction in North African women: results from a twenty-year experience.

Chamtouri¹,

Souissi²,

Amdouni³

et al. 2022

Journal of the Saudi Heart Association

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Background Coronary artery disease remains the most common cause of morbidity and mortality in the general population. Several studies in developed countries have reported a gender-related difference in ST-segment elevation myocardial infarction (STEMI) in terms of risk factors, clinical presentation, delays in management, therapeutic modalities, and in-hospital as well as one-year outcomes. Data from non-developed countries about women with STEMI remain rare. We therefore aimed through this study to investigate the baseline characteristics of STEMI in Tunisian women compared to men and to determine the impact of gender difference on STEMI complications, in-hospital mortality, and one-year follow-up outcomes. Methods All patients presenting to our center for STEMI between January 2001 and January 2021 were retrospectively enrolled in this analysis. Clinical features, therapeutic management, and in-hospital as well as one-year outcomes were compared between women and men. Predictive factors of in-hospital mortality in women were determined. Results Out of 1670 STEMI hospitalizations, 359 (21.4%) were female. Compared to male, female had higher rates of hypertension (51.5% vs. 24.4%, p < 0.001), diabetes (50.1% vs. 32.2%, p < 0.001), and obesity (63.8% vs. 55%, p = 0.003). The clinical presentation was characterized by less prevalent inaugural chest pain (58.8% vs. 68.6%, p < 0.001). Atypical symptoms were significantly higher in women compared to men (55.2% vs. 5%, p<0.001). On admission, women had higher prevalence of anemia, renal failure, and hyperglycemia compared to men. Primary percutaneous coronary intervention (pPCI) was the reperfusion strategy of choice in 37.9% of women vs. 33.1% of men (p=0.02). Women were significantly less likely to receive thrombolysis (p = 0.004), with a significantly less prevalent successful thrombolysis (55.6% vs. 67.2%, p=0.013). In-hospital mortality was markedly higher in women compared to men (12.8% vs. 7.3%, p=0.001). Compared to surviving women (n = 313), those who died (n = 46) frequently had more diabetes and hypertension (65.2% vs. 47.9%, p= 0.02 and 67.4% vs. 49.2%, p = 0.02, respectively). New-onset atrial fibrillation, acute left heart failure, cardiogenic shock, ventricular tachycardia, and atrioventricular block markedly occurred in women who died (52.2% vs. 23.3%, p=<0.001; 17.4% vs. 1.9%, p < 0.001; 19.6% vs. 8.3%, p = 0.016; 15.2% vs. 1.6%, p < 0.001 and 34.8% vs. 10.2%, p < 0.001, respectively). Conclusion Compared to men, Tunisian women presenting for STEMI had higher prevalence of risk factors and atypical symptoms. Women had more in-hospital complications and mortality.

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The impact of gender on mortality after NSTEMI

et al. 2018

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Controversies in the Treatment of Women with ST-Segment Elevation Myocardial Infarction

Cited by 3 publications

References 112 publications

Effect of Gender on the Outcomes of ST-Elevation Myocardial Infarction at a Tertiary Care Hospital in Riyadh, Saudi Arabia

Effect of Gender on the Outcomes of ST-Elevation Myocardial Infarction at a Tertiary Care Hospital in Riyadh, Saudi Arabia

ST-segment elevation myocardial infarction in North African women: results from a twenty-year experience.

The impact of gender on mortality after NSTEMI

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