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Gender-related benefit of transport to primary angioplasty: is it equal?
Marcin Sadowski1, Agnieszka Janion-Sadowska, Mariusz Gąsior
1Swietokrzyskie Cardiology Center, Kielce, Poland. emsad@o2.pl
Insights
Immediate reperfusion is critical for ST-segment elevation myocardial infarction (STEMI) patients. Women with STEMI face higher mortality risks, underscoring the need for rapid treatment to reduce deaths.
Area of Science:
- Cardiology
- Emergency Medicine
- Public Health
Background:
- Infarct size correlates with coronary artery occlusion duration.
- Primary angioplasty transport improves outcomes, but sex-based prognosis differences are unclear.
- This study compares outcomes in men and women with ST-segment elevation myocardial infarction (STEMI) based on transport method.
Purpose of the Study:
- To compare outcomes in male and female STEMI patients undergoing primary angioplasty.
- To evaluate the impact of direct transport versus inter-hospital transfer on STEMI patient prognosis.
- To identify potential sex-based disparities in STEMI treatment and outcomes.
Main Methods:
- Retrospective analysis of a STEMI registry (June 2005 - May 2006).
- Inclusion of 10,708 patients who underwent primary angioplasty.
- Comparison of in-hospital and long-term mortality (1-12 months) between sexes and transport groups.
Main Results:
- In-hospital and long-term mortality were significantly higher in women than in men.
- Prognosis for women was similar regardless of direct transport or inter-hospital transfer.
- A trend towards higher mortality at 6 and 12 months was observed in women transferred from another hospital.
Conclusions:
- Immediate reperfusion is essential to reduce STEMI mortality.
- Women with STEMI are at a greater risk of death and require prompt treatment.
- Timely intervention is crucial, especially for female STEMI patients, to improve survival rates.
Background:
Infarct size is correlated with duration of coronary artery occlusion. Evidence suggests that transport for primary angioplasty improves outcomes, but there is no agreement regarding differences in prognosis between men and women. We compared outcomes in men and women with ST-segment elevation myocardial infarction (STEMI) transferred from another hospital against those who had been transported directly to an invasive treatment center.
Methods:
Data was collected between June 2005 and May 2006 from a registry of 26,035 patients with STEMI and in whom primary angioplasty had been performed.
Results:
A total of 10,708 patients underwent primary angioplasty. Of these, 3,359 men and 1,469 women were transported directly, while 4,135 men and 1,745 women were transferred from another site. In-hospital mortality and at one month, six months and 12 months after hospital discharge was significantly higher in women than in men. The prognosis of women transported directly was similar to that of women transferred from another site. However, there was a tendency, albeit insignificant, towards higher mortality at six and 12 months in women transported from another hospital.
Conclusions:
To reduce mortality in STEMI, an immediate reperfusion must not be delayed. This conclusion is valid particularly for women who are at greater risk of death.
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