Abstract 10982: Persistence of “Gender Gap” in St-segment Elevation Myocardial Infarction Networks

Abstract

Introduction: Prognosis and management of women with ST-segment elevation myocardial infarction remains controversial. Hypothesis: The gender (female sex) influences the prognosis and the care of patients in a regional myocardial infarction network. Methods: Outcomes of patients activated by the Catalan network between January 2010 and December 2011, were analyzed according to gender. Time intervals, revascularization proportion, type of revascularization, in-hospital all-cause mortality and complications, 30-day all-cause mortality and one-year all-cause mortality were evaluated. Results: From a total of 5831 patients activated by the myocardial infarction network, 4380 patients had a diagnosis of ST-segment elevation myocardial infarction, and 961 (21.9%) of them were women. Women were older (69.8±13.4 vs. 60.6±12.8, p<0.001), had a higher prevalence of diabetes (27.1% vs. 18.1%, pI (24.9% vs. 17.3%, p<0.001), and no reperfusion (8.8% vs. 5.2%, p<0.001) as compared with men. In addition, women had greater time delays in medical care (first medical contact-to-balloon: 132-minutes vs. 122-minutes, p<0.001; symptoms onset-to-balloon: 236-minutes vs. 210-minutes, p<0.001). Women presented higher percentages of overall in-hospital complications (20.6% vs. 17.4%, p=0.031), in-hospital mortality (4.8% vs. 2.6%, p=0.001), 30-day mortality (9.1% vs. 4.5%, p<0.001) and one-year mortality (14.0% vs. 8.3%, p<0.001) compared with men. Nevertheless, after multivariate adjustment, no differences in 30-day and one-year mortality were observed (30-day adjusted hazard ratio [95% confidence interval]: 1.25 [0.94-1.65], p=0.123; one-year adjusted hazard ratio [95% confidence interval]: 0.88 [0.69-1.07], p=0.128). . Conclusions: Despite a higher risk profile and poorer medical management, women present similar 30-day and one-year outcome as their male counterparts in the context of myocardial infarction network.