Abstract
Objectives: A conflict of evidence exists regarding the gender-based differences in outcomes after primary percutaneous coronary intervention (PCI), therefore, aim of this study was to compare the clinical characteristics, angiographic findings, and outcome of primary PCI for men and women. Methodology: Data for this study was extracted from a prospectively managed primary PCI database of the National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan. We included consecutive patients of either gender with STEMI undergone primary PCI. Data on clinical characteristics, angiographic finding, and post procedure outcomes for female were compared with male group and also with a propensity matched male cohort. Results: A total of 2400 patients were included with 421(17.5%) women. The mean age for the men and women were 54.44±11.16 and 57.17±11.01 years respectively; p<0.001. Women had significantly high prevalence of hypertension (61.0% vs. 39.1%; p<0.001), diabetes (37.1% vs. 23.9%; p<0.001), and obesity (18.5% vs. 13.5%; p=0.008). The median symptom onset to hospital arrival time was 216 [366-124] minutes vs. 180 [310-112] minutes; p=0.001 for women and men. In-hospital mortality rate was 3.8% vs. 2.5%; p=0.147 for female and unmatched male cohort, while it was 3.6% vs. 3.8%; p=0.855 for female and propensity matched male cohort. Conclusion: Gender-based differences persist in clinical profile of the patients with STEMI. Women are likely to be older in age with more diabetes, hypertension, and obesity. Gender-based difference in outcome of primary PCI is appears to be driven by differences in clinical profile as adjusted outcome is not different for men and women.
Highlights
Cardiovascular diseases (CVD) remains a leading cause of death among both male and female, but a significantly different epidemiological landscape has been observed for men and women along with evidence of different clinical expression of atherosclerosis and pathophysiology of disease.[1]
Data were stratified by gender and comparative analysis between men and women for clinical characteristics, angiographic characteristics, procedural details, and post procedure outcomes were performed by applying independent sample t-test for continuous variables, such as age, body mass index (BMI), symptom onset to hospital arrival time, hospital arrival to procedure time, total ischemic time, lesion length, fluoroscopic time, and contrast volume, and mean ± standard deviation (SD) and median [interquartile range (IQR)] were computed
More complex cardiovascular disease risk profile was observed for the female cohort with more hypertension (61.0% vs. 39.1%; p
Summary
Cardiovascular diseases (CVD) remains a leading cause of death among both male and female, but a significantly different epidemiological landscape has been observed for men and women along with evidence of different clinical expression of atherosclerosis and pathophysiology of disease.[1]. It can be partly attributed to the cardioprotective mechanism of the main female sex circulating hormone, the estrogen.[2,3] Where there is comparatively lower risk of development of diseases, but the clinical evidence suggest that the female gender as an independent prognostic indicator after acute coronary event. Various studies have found female gender to be associated with a significant increased risk of shortand long-term mortality after acute coronary event.[4,5,6,7,8,9,10,11,12,13] there exist a conflict of evidence as ample literature available suggesting either no gender differences in outcomes or attributing differences in outcomes with differences in baseline characteristics or increased burden of comorbidities in women due to relatively older age at presentation.[14,15]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
