Worse prognosis for women who underwent primary percutaneous coronary intervention for acute ST-elevation myocardial infarction.
Artigo
em Inglês
| IMSEAR
| ID: sea-40180
ABSTRACT
BACKGROUND:
Many reports have shown that female gender carries a worse prognosis when developing acute myocardial infarction (MI), whether or not reperfusion therapy is used. The primary percutaneous coronary intervention (1-PCI) is currently a preferable treatment for acute ST-elevation MI. However, the data concerning the difference between the outcomes in the treatment of the disease in men and women in Thailand is still insufficient. MATERIAL ANDMETHOD:
A prospective registry of acute ST-elevation MI patients who underwent 1-PCI at King Chulalongkorn Memorial Hospital from June 1999 to December 2002 were analyzed. Kaplan Meier survival analysis is used to determine the in-hospital mortality.RESULTS:
The consecutive 184 (F-52, M-131) patients who underwent 1-PCI were recruited. Female subjects were older (66.6 +/- 12 y versus 59.0 +/- 11.6 y, p < 0.01); they also had higher percentage of diabetes (45.1 versus 27.1, p < 0.01), but a fewer number of smoker (17.7 versus 66.2, p < 0.001). The percentage of patients who had cardiogenic shock tended to be higher in women (34.6 versus 19.9, p = 0.08); however, the number of anterior wall MI and ejection fraction were not different. The mean door to balloon time (109 +/- 95 versus 99 +/- 68 minutes) and pain to balloon time (454 +/- 271 versus 372 +/- 298 minutes) were not different in both groups. The angiographic success with TIMI 3 flow was achieved in 92.3% for females and 86.9% for the males. The in-hospital mortality was significantly higher in females (23.1 versus 6.1, p = 0.002). Univariate analyses demonstrated that the feminine gender, cardiogenic shock, smoking, ejection fraction less than 40, cardiac arrest prior PCI and angiographic were the predictors for in-hospital mortality. When using multivariate analyses by Cox proportional model, only cardiogenic shock, history of hypertension and angiographic success were the significant predictors. Women had 2.15 times of in-hospital mortality higher than males; however, the confidence interval cross-over 1 (0.74-6.42) and p value was 0.16.CONCLUSION:
Females tend to have a poor prognosis when they develop acute ST-elevation MI which requires treatment with 1-PCI.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Prognóstico
/
Tailândia
/
Idoso
/
Feminino
/
Humanos
/
Masculino
/
Angioplastia Coronária com Balão
/
Análise de Sobrevida
/
Fatores Sexuais
/
Pessoa de Meia-Idade
Tipo de estudo:
Estudo prognóstico
País/Região como assunto:
Ásia
Idioma:
Inglês
Ano de publicação:
2004
Tipo de documento:
Artigo
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