Female sex was not independently associated with in-hospital mortality in STEMI patients undergoing primary PCI after adjustment for clinical profile (adjusted OR 1.07; 95% CI 0.48-2.41; p=0.864).
Observational (n=512)
Does female sex independently predict in-hospital mortality in patients with STEMI undergoing primary PCI?
Higher in-hospital mortality in women with STEMI undergoing primary PCI is driven by a more adverse clinical profile (such as older age and comorbidities) rather than female sex itself.
Odds Ratio: 1.07 (95% CI 0.48–2.41)
Absolute Event Rate: 13.4% vs 7.5%
p-value: p=0.864
Background/Objectives: Sex differences in ST-elevation myocardial infarction (STEMI) outcomes persist despite advances in primary percutaneous coronary intervention (PCI), but whether female sex independently influences early mortality remains unclear. study aimed to assess sex-based differences in clinical characteristics, management, in-hospital outcomes and to determine whether female sex independently predicts in-hospital mortality. Methods: This retrospective observational study included 512 consecutive patients with STEMI presenting within 6 h of symptom onset and treated with primary PCI. Clinical, laboratory, echocardiographic and angiographic data were analyzed. The primary endpoint was in-hospital mortality. Multivariable logistic regression identified independent predictors of mortality. Results: Women comprised 32.0% of the cohort and were older than men (median 69 vs. 59 years, p < 0.001), with a higher prevalence of diabetes and hypertension, but lower rates of smoking (all p < 0.001). Women had lower hemoglobin levels and a higher prevalence of moderate-to-severe mitral regurgitation (17.1% vs. 8.0%, p = 0.004). Procedural characteristics, including door-to-balloon time and complete revascularization, were similar between sexes. Crude in-hospital mortality was higher in women (13.4% vs. 7.5%, p = 0.047); however, female sex was not independently associated with mortality after adjustment (adjusted OR 1.07, 95% CI 0.48–2.41; p = 0.864). Lower LVEF and reduced GFR were the strongest independent predictors of death. Conclusions: Higher mortality in women is primarily driven by a more adverse clinical profile rather than sex itself, emphasizing the importance of early risk stratification and management.
Cinezan et al. (Sat,) conducted a observational in ST-elevation myocardial infarction (STEMI) (n=512). Female sex vs. Male sex was evaluated on In-hospital mortality (adjusted OR 1.07, 95% CI 0.48-2.41, p=0.864). Female sex was not independently associated with in-hospital mortality in STEMI patients undergoing primary PCI after adjustment for clinical profile (adjusted OR 1.07; 95% CI 0.48-2.41; p=0.864).