Key result
In patients with acute MI due to critical ULMCA stenosis, female gender was not associated with significant differences in mortality up to 12 months compared to male gender.
Why the study?
Are there gender-related differences in mortality and clinical course among patients with acute myocardial infarction due to unprotected left main coronary artery disease?
Observational (n=643)
Yes
Are there gender-related differences in mortality and clinical course among patients with acute myocardial infarction due to unprotected left main coronary artery disease?
Answers are grounded in this paper and cite their sources.
In patients with acute myocardial infarction due to unprotected left main coronary artery stenosis, mortality is very high but does not significantly differ between men and women, with cardiogenic shock and advanced age being the strongest predictors of death.
BACKGROUND: Optimal management of patients with acute myocardial infarction (MI) due to critical stenosis of an unprotected left main coronary artery (ULMCA) is not established. However, data from observational studies and registries encourage to perform percutaneous coronary intervention (PCI) in high risk patients. We investigated gender-related discrepancies, clinical course and prognosis in patients with acute MI and ULMCA as an infarct-related artery. METHODS: A total of 643 consecutive patients (184 [28.6%] females and 459 [71.4%] males) with acute MI due to critical ULMCA stenosis were selected from the population of 121,526 patients hospitalized due to acute coronary syndromes between 2003 and 2006. The primary endpoints were in-hospital, 30-day, 6-month and 12-month mortality. RESULTS: Women were older than men with significantly higher proportion of women older than 65 and with unfavorable risk profile. The management in men and women was similar. There was no significant gender-related differences in mortality in all follow-up periods. In multivariate analysis cardiogenic shock, pulmonary edema, ST elevation myocardial infarction (STEMI) and advanced age significantly increased mortality, whereas successful PCI decreased mortality. CONCLUSIONS: No significant differences in clinical course, treatment and prognosis between men and women were noted. Mortality remained very high in both genders. The most unfavorable prognostic factors were cardiogenic shock, pulmonary edema, STEMI and advanced age. Percutaneous coronary angioplasty is feasible and offers high success rate in this subset of patients.
No takes yet. Share an insight, caveat, or question.
Sadowski et al. (2013) conducted an observational in Acute myocardial infarction due to critical stenosis of an unprotected left main coronary artery (ULMCA) (n=643). Female gender vs. Male gender was evaluated on In-hospital, 30-day, 6-month and 12-month mortality. In patients with acute MI due to critical ULMCA stenosis, female gender was not associated with significant differences in mortality up to 12 months compared to male gender.
Synapse has enriched 10 related papers. Consider them for comparative context: