Why the study?
Gender differences in mortality among patients with STEMI are recognized, but the specific factors contributing to hospital mortality separately in men and women remain less well known.
While in-hospital mortality is higher in women with STEMI compared to men, this difference is largely driven by age, as mortality is similar between genders in patients aged 65 and older.
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Women with STEMI may warrant closer bleeding surveillance; leaves open whether sex-specific strategies improve outcomes in younger patients.
Purpose: There are well-known gender differences in mortality of patients with ST-elevation myocardial infarction (STEMI). Our purpose was to assess factors of hospital mortality separately for men and women with STEMI, which are less well known. Patients and Methods: In 2018-2019, 485 men and 214 women with STEMI underwent treatment with primary percutaneous coronary intervention (PCI). We retrospectively compared baseline characteristics, treatments and hospital complications between men and women, as well as between nonsurviving and surviving men and women with STEMI. Results: Primary PCI was performed in 94% of men and 91.1% of women with STEMI, respectively. The in-hospital mortality was significantly higher in women than in men (14% vs 8%, p=0.019). Hospital mortality in both genders was associated significantly to older age, heart failure, prior resuscitation, acute kidney injury, to less likely performed and less successful primary PCI and additionally in men to hospital infection and in women to bleeding. In men and women ≥65 years, mortality was similar (13.3% vs 17.8%, p = 0.293). Conclusion: Factors of hospital mortality were similar in men and women with STEMI, except bleeding was more likely observed in nonsurviving women and infection in nonsurviving men.
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Marinšek et al. (2023) studied this question.
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