Prognosis analysis of female patients with ST-segment elevation myocardial infarction complicated with multivessel disease after primary angioplasty / 中华急诊医学杂志

ABSTRACT

Objective:To observe the clinical characteristics of female patients with ST-segment elevation myocardial infarction (STEMI) complicated with multivessel disease (MVD) undergoing direct percutaneous coronary intervention (PCI), and to explore the factors affecting the prognosis of female patients.Methods:In this retrospective cohort study. 1 033 patients (196 women) with STEMI combined with MVD who were admitted to our hospital from 2005 to 2015 and successful completed direct PCI within 24 h onset of symptom were enrolled. Patients’ baseline data, PCI data and follow-up results were recorded. Kaplan-Meier method was used to plot the survival curve. Cox regression model was used to screen the prognostic factors of STEMI patients with multivessel disease.Results:Compared with male patients, the age of female patients was significantly older, while the proportion of smoking history, family history of coronary heart disease, and stent implantation history was significantly lower, the time from onset to PCI was significantly longer, and the proportion of intraoperative slow blood flow/no-reflow was significantly higher among female patients. The mean follow-up time was 4 years, and the incidence of major adverse cardiovascular events (MACE) was higher in women than in men. The main factor affecting the prognosis of female patients was Killip cardiac function grade Ⅱ~Ⅳ ( HR=1.804, 95% CI 1.060~3.071, P<0.05). The number of lesions with >50% occlusion ( HR=1.808, 95% CI 1.123-2.912, P < 0.01) was a common risk factor for both men and women. Conclusions:Compared with male patients, there is more treatment delay among female patients with STEMI and MVD, the incidence of MACE is higher, and cardiac insufficiency is the main factor affecting the prognosis of female patients.