Gender differences in ST-segment elevation myocardial infarction: an analysis on treatment, complications and acute-phase mortality

Abstract

Abstract Funding Acknowledgements None. Background Primary angioplasty is the gold-standard treatment in ST-segment elevation myocardial infarction (STEMI). Previous studies have shown differences in the treatment of STEMI between men and women. Purpose To analyze the differences in the management of STEMI between both genders in a mediterranean settlement when it comes to angioplasty, timing of revascularization, complication rates and 30-day mortality. Methods A prospective, unicentric study of consecutive STEMI patients that were admitted to an Acute Cardiac Care Unit was performed from January 2010 to December 2022. We compared the differences between genders on timing of revascularization, complication rates and 30-day mortality. Results A total of 4616 patients were included between 01/01/2010 and 31/12/2022, 21.75% were women. Women were older than men (68.5 vs 61.4 years, p<0,001), but there were no differences on cardiovascular risk factors, infarct location or ejection fraction. Female sex was associated with higher Killip class (Killip ≥2 on admission 22.6% vs 17.9%, p=0.005), less angioplasty rates (88.4% vs 93.1%, p<0.001), longer timing of revascularization (median time 223 minutes vs 178 minutes, p<0.001), higher rates of heart failure during admission (16.2% vs 11.3%, p<0,001), mechanical complications (2.9% vs 1.4%, p=0.001) and higher 30-day mortality (8.8% vs 5.7%, p<0,001). Conclusions Women with STEMI are less likely to receive revascularization therapy, are admitted with a higher Killip class and have higher rates of post-STEMI complications and 30-day mortality than men.