Sex-related differences in patients undergoing direct angioplasty for acute myocardial infarction

Vacek, James L.; Rosamond, Thomas; Kramer, Paul H.; Crouse, Linda J.; Porter, Charles B.; Robuck, O. W.; White, Joan L.; Beauchamp, Gary D.

doi:10.1016/0002-8703(93)90399-t

Cited by 39 publications

(17 citation statements)

References 26 publications

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“…The higher mortality among women takes place during hospitalization, and becomes similar to that observed among men after hospital discharge; these fi ndings are comparable to those of other trials in which global mortality among women was higher during in-hospital progression and during clinical follow-up; however, after hospital discharge, mortality was similar in both groups 21,22 ; and during the clinical follow-up with the adjustment made by multivariate analysis, gender was no longer an independent risk factor for mortality 21,22,26 .…”

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

confidence: 85%

“…In our study, after the multivariate analysis, the factors related to a higher incidence of major events at six months were severe left ventricular dysfunction and multivessel involvement of coronary disease; the same was true for survival free of major events and/or stable angina. In our study, as well as in the studies conducted by Antoniucci et al 22 and Vacek et al 26 , no difference was found as to the incidence of complications among the groups after the procedure, even knowing that body surface is inversely related to the development of such complications being therefore more common among women 31,32 .…”

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

confidence: 56%

“…Our success in the procedure was similar in both groups: 91.7% in the male group and 87.8% in the female group (p = 0.3841), rates apparently lower than those published by Vacek et al 26 (91% and 95%; p = 0.08) and Antoniucci et al 22 (97% and 98%; p = 0.93); however, these authors considered a TIMI grade 2 or 3 fl ow distal from the treated lesion as a successful outcome, whereas in our institution, only a TIMI grade 3 fl ow was considered as satisfactory. Had we considered a TIMI grade 2 or 3 fl ow as satisfactory, our success rate would have been 100% and 96.9%, respectively.…”

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

confidence: 44%

“…In other studies, mortality among women was signifi cantly higher; however, after adjusting the clinical characteristics of the groups, namely age, gender was no longer an independent risk factor for mortality 21,22,26 . Nevertheless, there are differences between these studies and our own, especially the longer period between symptom onset and reperfusion and the inclusion of patients in cardiogenic shock 21,22 .…”

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

confidence: 65%

“…In the three studies, there was no difference in the clinical follow-up as to clinical 26 or angiographic 22 restenosis and target lesion revascularization 21,26 , even though the studies on restenosis showed an inverse relation between artery reference diameter and incidence of restenosis 32,33 . In our study, as well as in that conducted by Antonioucci et al 22 , despite the signifi cantly smaller reference diameter of the infarct-related artery in the female group, in both groups it was on average greater than 3.0 mm (in Antoniucci's study it was 3.11 ± 0.49 and 3.02 ± 0.41 mm, respectively), and, perhaps for this reason, the levels of clinical restenosis were similar in both groups.…”

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

confidence: 83%

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

confidence: 85%

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

confidence: 56%

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

confidence: 44%

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

confidence: 65%

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

confidence: 83%

See 3 more Smart Citations

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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Sex-Based Analysis of Outcome in Patients With Acute Myocardial Infarction Treated Predominantly With Percutaneous Coronary Intervention

Mehilli

Kastrati²,

Dirschinger³

et al. 2002

JAMA

144

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Sex Differences in Short-term and Long-term All-Cause Mortality Among Patients With ST-Segment Elevation Myocardial Infarction Treated by Primary Percutaneous Intervention

et al. 2014

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IMPORTANCE Although outcomes in patients with ST-segment elevation myocardial infarction (STEMI) have improved in the past 2 decades, a sex disparity exists in survival, with women having higher mortality than men. OBJECTIVE To conduct a meta-analysis of observational studies that examined differences in mortality by sex in patients with STEMI treated with primary percutaneous coronary intervention (PPCI). DATA SOURCES MEDLINE, EMBASE, Cochrane central, and electronic databases were searched for relevant studies in all languages and without time restriction. STUDY SELECTION Studies were included if (1) they studied patients who presented with STEMI, (2) primary percutaneous coronary intervention (PPCI) was the treatment for STEMI, (3) PPCI was performed within 12 hours of symptom onset, and (4) sex-specific in-hospital and/or 1-year mortality were reported. DATA EXTRACTION AND SYNTHESIS Two investigators independently reviewed retrieved citations and assessed eligibility. Discrepancies were resolved by consensus. Quality of included studies was assessed using Newcastle-Ottawa Quality Assessment Scale for cohort studies. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES Sex-specific in-hospital and 1-year all-cause mortality. Risk ratios (RRs) of mortality were used for these 2 time points, if reported. RESULTS Of the 149 studies identified, 35 met inclusion criteria, representing 18 555 women and 49 981 men. In the unadjusted analyses, women were at a higher risk for in-hospital (RR, 1.93; 95% CI, 1.75-2.14 [P < .001, I 2 = 14%]) and 1-year all-cause mortality (RR, 1.58; 95% CI, 1.36-1.84 [P < .001, I 2 = 51%]) compared with men. However, when adjusted RRs were used, the association between women and higher risk of all-cause mortality was attenuated but still significantly elevated for in-hospital mortality (RR, 1.48; 95% CI, 1.07-2.05 [P = .02, I 2 = 56%]), but the higher risk for 1-year mortality in women was no longer significant (RR, 0.90; 95% CI, 0.69-1.17 [P = .42, I 2 = 58%]). CONCLUSIONS AND RELEVANCE An increased mortality in women with STEMI treated with PPCI was detected in this large meta-analysis but is likely confounded by baseline cardiovascular risk factors and the differences in clinical profile of male and female patients with STEMI. Intensive cardiovascular risk modification efforts in women may help to reduce this sex disparity.

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Sex-related differences in patients undergoing direct angioplasty for acute myocardial infarction

Cited by 39 publications

References 26 publications

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

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

Sex-Based Analysis of Outcome in Patients With Acute Myocardial Infarction Treated Predominantly With Percutaneous Coronary Intervention

Sex Differences in Short-term and Long-term All-Cause Mortality Among Patients With ST-Segment Elevation Myocardial Infarction Treated by Primary Percutaneous Intervention

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