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In-hospital management and outcome in women with acute myocardial infarction (data from the AMI-Florence Registry).
- Source :
-
The American journal of cardiology [Am J Cardiol] 2004 Nov 01; Vol. 94 (9), pp. 1118-23. - Publication Year :
- 2004
-
Abstract
- Primary percutaneous coronary intervention proved to be superior to thrombolysis in reducing ST-segment elevation acute myocardial infarction (STEAMI) mortality. However, whether such benefit is similar in women and men remains unclear. The aim of the present analysis was to assess the independent effect of female gender on management and on early and 1-year mortality in Florence, Italy, where primary percutaneous coronary intervention is the preferred reperfusion strategy for STEAMI. The study included a cohort of 920 unselected patients with STEAMI (men = 627, women = 293) prospectively enrolled in the AMI-Florence, population-based registry over 12 months. Women were older (76 vs 68 years, p <0.001) and more frequently had Killip class >I heart failure than men. The median delay to hospital admission was marginally longer in women (160 vs 130 minutes, p = 0.09). Coronary reperfusion treatment was performed less often in women (49% vs 58%, p <0.013); primary percutaneous coronary intervention was performed more often in both genders (90% vs 91%) and with similar median door-to-balloon time (50 vs 45 minutes, p = 0.44). Both in-hospital (16% vs 8%, p <0.001) and 1-year mortality (25% vs 18%, p = 0.016) were higher in women. However, after adjusting for age and other baseline characteristics, reperfusion treatment (odds ratio 1.27, 95% confidence interval [CI] 0.78 to 2.08) and 1-year mortality (hazard ratio [HR] 0.91, 95% CI 0.67 to 1.24) were independent of female gender. Compared with conservative therapy, reperfusion treatment was associated with a similar reduction in 1-year mortality in women (HR 0.59, 95% CI 0.34 to 1.02) and men (HR 0.58, 95% CI 0.37 to 0.92). Our data suggest that older age and several age-related factors may largely account for the higher mortality of women after STEAMI. Even in the general population,improvement in prognosis associated with reperfusion treatment is independent of gender.
- Subjects :
- Adrenergic beta-Antagonists therapeutic use
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary
Female
Follow-Up Studies
Hospital Mortality
Humans
Italy epidemiology
Male
Myocardial Infarction epidemiology
Myocardial Reperfusion
Platelet Glycoprotein GPIIb-IIIa Complex therapeutic use
Sex Factors
Time Factors
Treatment Outcome
Women's Health
Myocardial Infarction therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9149
- Volume :
- 94
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 15518604
- Full Text :
- https://doi.org/10.1016/j.amjcard.2004.07.076