Abstract
Several epidemiological and clinical studies have shown that females with ST-segment elevation myocardial infarction (STEMI) have a higher mortality than males following primary percutaneous coronary intervention (PPCI). Many analyses of sex-based differences following STEMI have revealed conflicting results. Currently, more and more elderly patients with STEMI have undergone emergency interventional therapy. From January 2014 to December 2016, a total of 337 elderly patients with STEMI were enrolled in this study from two chest pain centers, and all patients underwent PPCI. Patients were divided into two groups: elderly females (n=117, mean age 73.4±9.6 years) and elderly males (n=220, mean age 71.7±8.6 years). The prevalence of diabetes was higher in females than in males (29.1% vs. 19.6%,P<0. 01). Typical ischemic chest pain was lower in females than in males (45.3% vs 57.3%, P<0.01). The number of nonsmokers was also significantly higher in females than in males (5.1% vs. 52.3%,P<0. 01). Serum creatinine (sCr) levels (87.6±17.4 umol/L vs 99.5±20.2 umol/L,P<0.01) and body mass index (23.8±2.7 vs 27.3±3.1, P<0.01) were lower in females than in males. The incidences of major adverse cardiac events (MACE) in-hospital showed no significantly difference (P>0.05) between the two groups. However, the cumulative MACE showed a significant difference between the two groups in the 12-month follow-up (16.8% in male vs 12.8% in female, P = 0.04). Our results suggest that the PPCI is safe and effective in elderly female STEMI patients. The cumulative MACE in females are not higher than in males. PPCI are helpful in elderly STEMI patients.
Highlights
The influence of patient gender on outcomes of acute myocardial infarction (AMI) is controversial
Our results suggest that the Primary percutaneous coronary intervention (PCI) (PPCI) is safe and effective in elderly female segment elevation myocardial infarction (STEMI) patients
The AMI diagnostic criteria were based on the European Society of Cardiology (ESC) Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation [10]
Summary
The influence of patient gender on outcomes of acute myocardial infarction (AMI) is controversial. Data from a study of 45,852 patients in the COMMIT/CCS-2 study showed that compared with males of the same age, females had approximately a 50% higher mortality following hospital admission for ST-segment elevation myocardial infarction (STEMI) [2]. The China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Retrospective Study indicated that females experienced a higher increase in hospitalization rates for STEMI in China between 2001 and 2011 and were less likely to receive evidence-based aggressive therapies, especially revascularization and reperfusion. Data from the MITI study and the Cooperative Cardiovascular Project suggested that during acute treatment of myocardial infarction a somewhat less aggressive therapy was performed in females as compared with males [7], suggesting that intensive cardiovascular risk modification efforts in females may help to reduce this sex disparity. In the present study, based on a series of Chinese patients who living in south china admitted for STEMI, we (1) analyzed the clinical characteristics of STEMI elderly patients who underwent Primary PCI (PPCI); (2) evaluated the safety and efficacy of PPCI in these patients; and (3) evaluated the impact of gender on mortality and complications and mainly focused on MACE and mortality during one-year follow-up
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