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Sex differences and survival in latecomers with ST-elevationmyocardial infarction

Authors: Konovalova E.V., Luk'yanova Yu.V., Gorev M.V., Reztsov R.Yu., Makarycheva O.V., Vasilieva E.Yu., Shpektor A.V. 

Company: Cardiology Chair for Post-Diploma Education Faculty of Moscow State University of Medicine and Dentistry named after A.I. Evdokimov of Ministry of Health of the Russian Federation; Delegatskaya ulitsa, 20/1, Moscow, 127473, Russian Federation

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DOI: https://doi.org/10.15275/kreatkard.2016.04.03

For citation: Konovalova E.V., Luk'yanova Yu.V., Gorev M.V., Reztsov R.Yu., Makarycheva O.V., Vasilieva E.Yu., Shpektor A.V. Sex differences and survival in latecomers with ST-elevationmyocardial infarction. Creative Cardiology. 2016; 10 (4): 290-295 (in Russ.).

Keywords: revascularization acute coronary syndrome survival rates prognosis gender

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Abstract

Objective. The early outcomes after acute myocardial infarction (AMI) are better in men than in women. The aim of this study was to evaluate the gender differences in the long-term prognosis in patients with ST-elevation myocardial infarction (STEMI) hospitalized after 12 hours from symptoms onset.
Material and methods. The data of 178 patients (117 (66%) men), with STEMI hospitalized later than 12 hours after the onset of symptoms was retrospectively analyzed. The mean time from the symptoms onset to the admission was 96.6 hours. Percutaneous coronary intervention (PCI) was performed in 83 (47%) patients 59 (71.1%) men. Other 95 (53%) patients (58 (61.1%) men), were treated conservatively. The 3-year mortality was evaluated using Kaplan–Meier estimation.
Results. The 3-year mortality was higher in women than in men hospitalized later than 12 hours from symptoms onset (36% vs. 19.6, HR 0.54, 95% confidence interval (CI) 0.33–0.89, p=0.009). The long term mortality in women who underwent revascularization was 16% (4 pts), while in the conservative treatment group it was 48% (18 pts) (HR 0.29, 95% CI 0.11–0.77, p=0.001). Long term mortality in men who underwent PCI was (7 pts), in the conservative treatment group – 28% (16 pts) (HR 0.43, 95% CI 0.19–0.96, p=0.024). In the PCI group the long term survival did not differ in women and in men (HR 0.71; 95% CI 0.22–2.21, p=0.5).
Conclusion. Although the long-term prognosis is worse in women with STEMI hospitalized late after symptoms onset in comparison to men, PCI in women with STEMI admitted more than 12 hours after the onset of symptoms leads to improved long term prognosis.

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Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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