TCT-366 Impact of gender on adverse cardiac events in patients with large anterior myocardial infarction: Results from the INFUSE-AMI trial

Abstract

Background: Women have less favorable outcomes compared with men after ST-segment elevation myocardial infarction (STEMI) for as yet unclear reasons. Methods: The INFUSE-AMI trial randomized patients with STEMI due to proximal or mid LAD occlusion to intracoronary bolus abciximab (ClearWay RX catheter) vs. no abciximab, and to thrombus aspiration (Export) vs. no aspiration. We compared infarct size as % of LV mass assessed by magnetic resonance imaging at 30-days, angiographic and electrocardiographic markers of reperfusion and 30-day major adverse cardiovascular events (MACE) according to gender. Results: Among 452 patients, women (118, 26.1%) were older, and had a higher prevalence of hypertension, hyperlipidemia and diabetes. They were more likely to undergo PCI 3 hours after the onset of symptoms (47.5% vs. 25.1 %, p 0.0001). There were no significant differences among men and women in post-procedure TIMI 3 flow, 89.8% vs. 91.9%; myocardial blush grade 3, 67.8% vs. 70.0%; complete ST resolution, 56.9% vs. 50.3% and infarct size, median [IQR] % total LV mass, 17.0% [6.8-24.8] vs. 17.3% [9.5-23.5]. Unadjusted MACE at 30 days was higher in women (Fig) but after adjustment for confounders, female gender was not significantly associated with increased MACE (HR 1.59, 95% CI 0.75-3.33, p 0.23).