Sex-based differences in clinical and angiographic outcomes after primary angioplasty or stenting for acute myocardial infarction

Antoniucci, David; Valenti, Renato; Moschi, Guia; Migliorini, Angela; Trapani, Maurizio; Santoro, Giovanni Maria; Bolognese, Leonardo; Dovellini, Emilio Vincenzo

doi:10.1016/s0002-9149(00)01360-6

Cited by 79 publications

(66 citation statements)

References 21 publications

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“…14) Some papers have showed that women died more frequently, especially the older ones and those presenting with acute myocardial infarction, compared to men. 8,9) Our results are contrary to previously cited papers. Women underwent coronary angioplasty with consecutive revascularization, either percutaneous or surgical, as often as men.…”

Section: Discussioncontrasting

confidence: 99%

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Analysis of Myocardial Infarction Time Course in Women Compared With Men in Upper Silesia Population in 30 Day Follow-Up

et al. 2009

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SummaryThe aim of the study was to compare the course of myocardial infarction in women versus men in Upper Silesia, an industrial region in the south of Poland.The study comprised 1003 patients with either ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). The patients were divided into group 1 (300 females) and group 2 (control, 703 males). The groups differed significantly with respect to age, incidence of hypertension, diabetes, and smoking. In group 1 STEMI occurred significantly less frequently than NSTEMI. Taking this into account, we divided the studied cohort into group A (STEMI patients) and group B (NSTEMI patients), each subdivided into women and men.In the 30 day long follow-up, group 1 patients had significantly lower creatine kinase activity, higher occurrence of ventricular tachycardia, lower percentage of intra-aortic balloon pump use, and longer hospital stay compared with group 2. Group 1 was characterized by significantly higher mortality and target lesion reocclusion (TLR).The medical course of myocardial infarction in women is similar to that in men, as is the treatment of acute coronary syndrome. In our study, patients from both groups underwent invasive examination with consecutive interventional treatment with similar frequency. However, this finding is not reflected in the outcomes. Women had higher risks of death and TLR in 30 day follow-up. Taking this into consideration, we should attempt to identify the factors responsible for this situation by expanding the analysis to a larger population to allow firm conclusions to be drawn. (Int Heart J 2009; 50: 711-721)

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Section: Discussioncontrasting

confidence: 99%

“…1,7) Some authors stress the delay in diagnosis and the institution of appropriate treatment in women. 8) Despite all these proved facts, the impact of gender itself on mortality in acute coronary syndromes is uncertain. Is the female gender an independent risk factor of acute coronary syndromes?…”

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confidence: 99%

Analysis of Myocardial Infarction Time Course in Women Compared With Men in Upper Silesia Population in 30 Day Follow-Up

et al. 2009

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“…and the greater reference diameter of their vessels have been reproduced in several studies on the subject 21,22 . Diabetes is related to the worst progression and, generally speaking, has a higher incidence in women 22,23,24 .…”

Section: Gender Influence On the Immediate And Medium-term Progressiomentioning

confidence: 99%

Influência do sexo na evolução imediata e a médio prazo após a intervenção coronariana percutânea primária e análise dos fatores independentes de risco para óbito ou eventos

Peixoto¹,

Peixoto²,

Sena³

et al. 2006

Arq. Bras. Cardiol.

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OBJECTIVEDetermine gender-related differences and risk factors for death and events, both in-hospital and at six-month evolution, of patients admitted within the fi rst twelve hours of ST-segment elevation acute myocardial infarction and who underwent primary percutaneous coronary intervention. METHODSBetween July 1998 and December 2000, 199 consecutive patients were enrolled in the study, with elevation myocardial infarction and without cardiogenic shock, outcome, in-hospital and six-month progression were studied. RESULTSClinical characteristics were similar in both groups, except that women were older than men (67.04 ± 11.53 x 59.70 ± 10.88, p < 0.0001). In-hospital mortality was higher among women (9.1% x 1.5%, p = 0.0171), as was the incidence of major events (12.1% x 3.0%, p = 0.0026). The difference in mortality rates remained the same at six months (12.1% x 1.5%, p = 0.0026). The multivariate analysis predicted death: female gender and an age over eighty years, and major events and/or stable angina multivessel: disease and severe ventricular dysfunction. CONCLUSIONFemale gender and an age over eighty years were independent predictors of mortality, six months of patients who had undergone primary percutaneous intervention. KEY WORDSPrimary coronary angioplasty, acute myocardial infarction, gender, risk factors.

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] As regards gender, various data suggest that it is not an independent adverse prognosticator, but that it is frequently related to high-risk profile and worse coronary angiographic pattern. 13,14 On the other hand, the reasons why elderly patients have a worse prognosis even after successful reperfusion are not completely clear, and apparently neither larger infarct size nor lower LVEF are involved as causative mechanisms. 11,12 On these premises, we tried to verify whether gender and older age influence the relationship between infarct dimensions and LVEF.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 As regards gender, it is known that women show a worse prognosis than men, but this is seemingly related to older age, high-risk factor profile, and unfavorable angiographic features and not to an intrinsic adverse prognostic meaning of female sex. 13,14 Furthermore, previous data suggest that female sex is associated with a smaller infarct size. 15,16 However, the interaction between gender, infarct size, and LVEF has not been established.…”

Section: Introductionmentioning

confidence: 98%

Evaluation of the influence of age and gender on the relationships between infarct size, infarct severity, and left ventricular ejection fraction in patients successfully treated with primary percutaneous coronary intervention

Sciagrà

Parodi

Migliorini

et al. 2010

Journal of Nuclear Cardiology

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Background. Female sex and advanced age have adverse prognostic meaning in acute myocardial infarction. Whether gender and/or age influence the relationship between infarct size, infarct severity, and left ventricular ejection fraction (LVEF) is unclear.Methods. We examined 460 patients (359 men) with acute myocardial infarction submitted to successful primary percutaneous coronary intervention. Infarct size, infarct severity, and LVEF were evaluated with perfusion gated SPECT at one month of index infarction.Results. There were no significant correlations between age and infarct size or infarct severity, and between age and LVEF. Moreover, elderly age ( ‡75 years) did not influence the relationship between LVEF and infarct size or infarct severity. Conversely, there was a significant gender-related difference in the relationship between LVEF and infarct size (F 5 20.5, P < .00001), and between LVEF and infarct severity (F 5 8.6, P < .005). In practice, there was a steeper decrease in LVEF in case of moderate to large infarct size in women than in men.Conclusion. With increasing infarct size, LVEF decreases more sharply in women than in men. Conversely, age does not influence the relationship between infarct dimensions and LVEF. (J Nucl Cardiol 2010)

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Sex-based differences in clinical and angiographic outcomes after primary angioplasty or stenting for acute myocardial infarction

Cited by 79 publications

References 21 publications

Analysis of Myocardial Infarction Time Course in Women Compared With Men in Upper Silesia Population in 30 Day Follow-Up

Analysis of Myocardial Infarction Time Course in Women Compared With Men in Upper Silesia Population in 30 Day Follow-Up

Influência do sexo na evolução imediata e a médio prazo após a intervenção coronariana percutânea primária e análise dos fatores independentes de risco para óbito ou eventos

Evaluation of the influence of age and gender on the relationships between infarct size, infarct severity, and left ventricular ejection fraction in patients successfully treated with primary percutaneous coronary intervention

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