Gender Differences among Elderly Patients with Primary Percutaneous Coronary Intervention

Abstract

Several epidemiological and clinical studies have shown that females with ST-segment elevation myocardial infarction (STEMI) have a higher mortality than males following primary percutaneous coronary intervention (PPCI). Many analyses of sex-based differences following STEMI have revealed conflicting results. Currently, more and more elderly patients with STEMI have undergone emergency interventional therapy. From January 2014 to December 2016, a total of 337 elderly patients with STEMI were enrolled in this study from two chest pain centers, and all patients underwent PPCI. Patients were divided into two groups: elderly females (n=117, mean age 73.4±9.6 years) and elderly males (n=220, mean age 71.7±8.6 years). The prevalence of diabetes was higher in females than in males (29.1% vs. 19.6%,P<0. 01). Typical ischemic chest pain was lower in females than in males (45.3% vs 57.3%, P<0.01). The number of nonsmokers was also significantly higher in females than in males (5.1% vs. 52.3%,P<0. 01). Serum creatinine (sCr) levels (87.6±17.4 umol/L vs 99.5±20.2 umol/L,P<0.01) and body mass index (23.8±2.7 vs 27.3±3.1, P<0.01) were lower in females than in males. The incidences of major adverse cardiac events (MACE) in-hospital showed no significantly difference (P>0.05) between the two groups. However, the cumulative MACE showed a significant difference between the two groups in the 12-month follow-up (16.8% in male vs 12.8% in female, P = 0.04). Our results suggest that the PPCI is safe and effective in elderly female STEMI patients. The cumulative MACE in females are not higher than in males. PPCI are helpful in elderly STEMI patients.

Sex-related impacts on clinical outcomes after percutaneous coronary intervention

“…And women have a higher life expectancy than men, which is due to differences in deaths from injuries, lung cancer, and cardiovascular diseases, which may be related to the differential hormonal effects, genetic predisposition 21 and smoking habits 22 . In another eastern Asian study, elderly women with STEMI showed better clinical outcomes 1 year after primary PCI than men 23 . Furthermore, there was a higher smoking rate in men than women (52.3% vs. 5.1%) in that study.…”

Symptoms of Infarction in Women: Is There a Real Difference Compared to Men? A Systematic Review of the Literature with Meta-Analysis

“…The “confirmed ACS” subgroup represented 1,195,524 patients, including 494,641 women. Patients included in the studies were admitted to emergency departments for chest pain, ACS suggestive symptoms according to the receiving physicians [ 10 , 12 , 16 , 17 , 18 , 20 , 21 ] or ACS suspicion from troponin measurement [ 11 , 13 ], or were hospitalized for ACS [ 9 , 14 , 15 , 19 , 22 , 23 ].…”

“…Indeed, all the studies were prospective and therefore did not rely on a posteriori collection of the symptoms of ACS presented by the patients. Data collection was standardized in each of the studies by systematic collection by the investigators [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Carrying out the analysis of the “Confirmed ACS” subgroup allowed us to analyze the symptoms even better.…”

“…Lately, several authors were interested in the ACS differences between men and women [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. First of all, physiopathologically, men and women are not exposed to cardiovascular risk factors in the same way.…”

Sex Disparities in Access to Surgical Care at a Single Institution in Malawi

“…Women's roles as caregivers drive them to prioritize their families' needs over their own, or patriarchal social norms lead to difficulties in women being able to express their needs [3]. Sexbased disparities in outcomes may also simply be attributable to a sex-based predilection to the specific disease or underlying biological differences between men and women, as is seen in symptom and treatment patterns in women with acute coronary syndrome [25][26][27][28][29].…”