ST-segment elevation myocardial infarction: are women being discriminated?

Abstract Background Although outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (PCI) have improved, a gender disparity exists, women showing higher mortality. Objectives To assess differences presentation, management and in-hospital, at 30-days, 6-months 1-year after STEMI Methods We collected data from 809 consecutive treated PCI compared the females versus males. Results Women were older than man (69,1±14,6 vs. 58,5±12,7 years; p<0.001) prevalence of age over 75 years (36.7% 11.7%; p<0.001), diabetes (30,6% 18,5%; p=0.001), hypertension (60.5% 45.9%; chronic kidney disease (3.4% 0.6%; p=0.010) acute ischemic stroke (6.8% 3.0%; p=0.021). At had more atypical symptoms, less chest pain (90.3% 95.6%; p=0.014) greater clinical severity (cardiogenic shock (10.7% 5.4%; p=0.011). There no symptom-first medical contact me (95.0 min 80.5 min; p=0.215); however, longer time until reperfusion (264.0 212.5 p=0.001) likely to receive optimal therapy (aspirin-93.1% 99.2%; p<0.001; P2Y12 inhibitors 91.9% 98.2%; beta-blockers-90.8% 95.1%; p=0.032; ACEIs- 88.1% 94.8%; p=0.003). In-hospital mortality (9.6% 3.5%; 30-days (11.3% 4.0%; (14.1% 4.7%; (16.4% 6.3%; was significantly women. The multivariate analysis identified (HR=4.25; 95% CI [1.67–10.77]; p=0.002), Killip class II (HR=8.80; [2.72–28.41]; III (HR=5.88; [0.99–34.80]; p=0.051) IV (HR=9.60; [1.86–48.59]; p=0.007), injury (HR=2.47; [1.00–6.13]; days hospitalization (HR=1.04; [1.01–1.08]; p=0.030) but not female (HR=0.83; [0.33–2.10]; p=0.690) as independent prognostic factors Conclusions Compared men, rates. Our results suggest that this is due itself, worse risk profile, related system delays minor probability receiving recommended therapy. Efforts should be made reduce these differences. FUNDunding Acknowledgement Type funding sources: None.