The impact of gender on the outcomes of invasive versus conservative management of patients with non-ST-segment elevation myocardial infarction
Annals of the Academy of Medicine, Singapore
; : 168-172, 2010.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-253602
Biblioteca responsável:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>Studies have suggested that women who present with non-ST-segment elevation myocardial infarction (NSTEMI) may differ in their clinical response to early invasive strategy compared to male patients. We examined the impact of gender difference in NSTEMI patients on outcomes following invasive versus conservative treatment.</p><p><b>MATERIALS AND METHODS</b>Patients enrolled in our national myocardial infarction (MI) registry between January 2000 and September 2005 with diagnosis of NSTEMI were retrospectively analysed. The study endpoint was the occurrence of major adverse cardiac events (MACE) in the patients at 1 year.</p><p><b>RESULTS</b>A total of 1353 patients (62.2% male) with NSTEMI were studied. The mean age of men was 62 +/- 14 versus 72 +/- 12 years in women in the cohort (P <0.001). The prevalence of hypertension and diabetes mellitus were significantly higher in women. Men were more likely to undergo revascularisation than women (OR, 2.97; 95% CI, 2.18-3.89, P <0.001). Among those who were revascularised, there was no gender difference in survival or recurrent MI rates during hospitalisation and at 1 year. Compared to medical therapy, percutaneous coronary intervention (PCI) was associated with a significant reduction in MACE in both women (OR, 0.44; 95% CI, 0.20-0.95) and men (OR, 0.40; 95% CI, 4.79-12.75). The most important predictor of MACE for females was diabetes mellitus (HR, 1.98; 95% CI, 1.17-3.33).</p><p><b>CONCLUSIONS</b>There is a gender-based difference in the rate of revascularisation among patients with NSTEMI. Women benefit from an invasive approach as much as men, despite their advanced age, with similar rates of mortality and recurrent MI at 1-year follow-up.</p>
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Doença Cardiovascular
/
Doença Isquêmica do Coração
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Recidiva
/
Cirurgia Geral
/
Padrões de Prática Médica
/
Inibidores da Enzima Conversora de Angiotensina
/
Inibidores da Agregação Plaquetária
/
Angioplastia Coronária com Balão
/
Análise de Sobrevida
/
Fatores Sexuais
/
Seguimentos
/
Antagonistas Adrenérgicos beta
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Aspecto:
Determinantes sociais da saúde
Limite:
Idoso
/
Idoso, 80 anos ou mais
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Annals of the Academy of Medicine, Singapore
Ano de publicação:
2010
Tipo de documento:
Artigo