Sex differences in treatment and outcomes of patients with in-hospital ST-elevation myocardial infarction.
Clin Cardiol
; 45(4): 427-434, 2022 Apr.
Article
in English
| MEDLINE | ID: covidwho-1797945
ABSTRACT
BACKGROUND AND HYPOTHESIS:
Two cohorts face high mortality after ST-elevation myocardial infarction (STEMI) females and patients with in-hospital STEMI. The aim of this study was to evaluate sex differences in ischemic times and outcomes of in-hospital STEMI patients.METHODS:
Consecutive STEMI patients treated with percutaneous coronary intervention (PCI) were prospectively recruited from 30 hospitals into the Victorian Cardiac Outcomes Registry (2013-2018). Sex discrepancies within in-hospital STEMIs were compared with out-of-hospital STEMIs. The primary endpoint was 12-month all-cause mortality. Secondary endpoints included symptom-to-device (STD) time and 30-day major adverse cardiovascular events (MACE). To investigate the relationship between sex and 12-month mortality for in-hospital versus out-of-hospital STEMIs, an interaction analysis was included in the multivariable models.RESULTS:
A total of 7493 STEMI patients underwent PCI of which 494 (6.6%) occurred in-hospital. In-hospital versus out-of-hospital STEMIs comprised 31.9% and 19.9% females, respectively. Female in-hospital STEMIs were older (69.5 vs. 65.9 years, p = .003) with longer adjusted geometric mean STD times (104.6 vs. 94.3 min, p < .001) than men. Female versus male in-hospital STEMIs had no difference in 12-month mortality (27.1% vs. 20.3%, p = .92) and MACE (22.8% vs. 19.3%, p = .87). Female sex was not independently associated with 12-month mortality for in-hospital STEMIs which was consistent across the STEMI cohort (OR 1.26, 95% CI 0.94-1.70, p = .13).CONCLUSIONS:
In-hospital STEMIs are more frequent in females relative to out-of-hospital STEMIs. Despite already being under medical care, females with in-hospital STEMIs experienced a 10-min mean excess in STD time compared with males, after adjustment for confounders. Adjusted 12-month mortality and MACE were similar to males.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Sexually Transmitted Diseases
/
Percutaneous Coronary Intervention
/
ST Elevation Myocardial Infarction
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Clin Cardiol
Year:
2022
Document Type:
Article
Affiliation country:
Clc.23797
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