TY - JOUR
T1 - Gender-related difference in ST-elevation myocardial infarction treated with primary angioplasty
T2 - A single-centre 6-year registry
AU - Valente, Serafina
AU - Lazzeri, Chiara
AU - Chiostri, Marco
AU - Giglioli, Cristina
AU - Zucchini, Mery
AU - Grossi, Francesco
AU - Gensini, Gian Franco
PY - 2012/4
Y1 - 2012/4
N2 - Objective: Still contrasting are data on the impact of sex on outcome in patients with ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI).Design: We sought sex-related differences in management and early outcomes in 1127 STEMI patients submitted to PCI consecutively admitted to our intensive cardiac care unit (ICCU) in Florence from 1 January 2004 to 31 December 2009.Results: Females were significantly older, leaner (p <0.001, respectively), more hypertensive (p <0.001), and diabetic (p = 0.016); they showed a higher incidence of neurological impairment (p = 0.002) and chronic obstructive pulmonary disease (p = 0.048). Higher Killip classes were more frequent in females (p = 0.015). Door-to-balloon time was higher in females (p <0.001) who showed a higher incidence of major bleeding (p <0.001) and a higher in-ICCU mortality rate (p = 0.037). The use of IIbIIIa glycoprotein inhibitors was lower in females (p <0.001) who exhibited higher values of admission glycaemia and peak glycaemia (p <0.001 and p <0.001, respectively), higher values of fibrinogen (p <0.001) and erythrocyte sedimentation rate (p <0.001), and lower eGFR and haemoglobin values (p <0.001).Conclusions: According to our data, STEMI women show not only a different risk profile (older age, comorbidities, lower haemoglobin values), but also a different gender-related metabolic and inflammatory responses to acute myocardial ischaemia in respect to men. All these factors can account for the higher in-ICCU mortality in women and strongly suggest that STEMI women deserve more intensive care due to a more severe haemodynamic derangement (as indicated by the higher use of inotropes, diuretics, and non-invasive ventilation) and to a more serious metabolic impairment (as inferred by higher glucose values).
AB - Objective: Still contrasting are data on the impact of sex on outcome in patients with ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI).Design: We sought sex-related differences in management and early outcomes in 1127 STEMI patients submitted to PCI consecutively admitted to our intensive cardiac care unit (ICCU) in Florence from 1 January 2004 to 31 December 2009.Results: Females were significantly older, leaner (p <0.001, respectively), more hypertensive (p <0.001), and diabetic (p = 0.016); they showed a higher incidence of neurological impairment (p = 0.002) and chronic obstructive pulmonary disease (p = 0.048). Higher Killip classes were more frequent in females (p = 0.015). Door-to-balloon time was higher in females (p <0.001) who showed a higher incidence of major bleeding (p <0.001) and a higher in-ICCU mortality rate (p = 0.037). The use of IIbIIIa glycoprotein inhibitors was lower in females (p <0.001) who exhibited higher values of admission glycaemia and peak glycaemia (p <0.001 and p <0.001, respectively), higher values of fibrinogen (p <0.001) and erythrocyte sedimentation rate (p <0.001), and lower eGFR and haemoglobin values (p <0.001).Conclusions: According to our data, STEMI women show not only a different risk profile (older age, comorbidities, lower haemoglobin values), but also a different gender-related metabolic and inflammatory responses to acute myocardial ischaemia in respect to men. All these factors can account for the higher in-ICCU mortality in women and strongly suggest that STEMI women deserve more intensive care due to a more severe haemodynamic derangement (as indicated by the higher use of inotropes, diuretics, and non-invasive ventilation) and to a more serious metabolic impairment (as inferred by higher glucose values).
KW - Female gender
KW - major bleeding
KW - metabolic and inflammatory responses
KW - mortality
KW - PCI
KW - ST-elevation myocardial infarction
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U2 - 10.1177/1741826711400511
DO - 10.1177/1741826711400511
M3 - Article
C2 - 21450581
AN - SCOPUS:84861234869
VL - 19
SP - 233
EP - 240
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
SN - 2047-4873
IS - 2
ER -