Gender Differences among Elderly Patients with Primary Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Geriatric Medicine
• Interventional Cardiology

Background:

• Sex-based disparities in ST-segment elevation myocardial infarction (STEMI) outcomes following primary percutaneous coronary intervention (PPCI) are debated, with conflicting results in existing literature.
• Elderly patients represent a growing demographic undergoing emergency interventional therapy for STEMI, necessitating sex-specific outcome analyses.
• Previous studies indicate potentially higher mortality rates in females compared to males post-STEMI and PPCI, warranting further investigation in the elderly population.

Purpose of the Study:

• To compare the safety and efficacy of primary percutaneous coronary intervention (PPCI) in elderly female versus male patients with ST-segment elevation myocardial infarction (STEMI).
• To analyze in-hospital and 12-month cumulative major adverse cardiac events (MACE) between elderly female and male STEMI patients undergoing PPCI.
• To identify potential sex-based differences in clinical characteristics and outcomes among elderly STEMI patients treated with PPCI.

Main Methods:

• A retrospective study involving 337 elderly STEMI patients (117 females, 220 males) who underwent primary percutaneous coronary intervention (PPCI) between January 2014 and December 2016.
• Patients were stratified into elderly female and elderly male groups for comparative analysis of baseline characteristics, in-hospital MACE, and 12-month cumulative MACE.
• Statistical analysis was performed to compare demographic data, comorbidities (e.g., diabetes), presenting symptoms, laboratory values (serum creatinine), body mass index, and adverse cardiac events between the sexes.

Main Results:

• Elderly females exhibited a higher prevalence of diabetes (29.1% vs. 19.6%) and lower rates of typical ischemic chest pain (45.3% vs. 57.3%) and nonsmokers (5.1% vs. 52.3%) compared to males.
• Females had lower serum creatinine levels (87.6±17.4 vs. 99.5±20.2 umol/L) and body mass index (23.8±2.7 vs. 27.3±3.1) than males.
• No significant difference in in-hospital major adverse cardiac events (MACE) was observed between groups (P>0.05); however, cumulative MACE at 12 months was significantly lower in females (12.8% vs. 16.8% in males, P=0.04).

Conclusions:

• Primary percutaneous coronary intervention (PPCI) is a safe and effective treatment for elderly female patients experiencing ST-segment elevation myocardial infarction (STEMI).
• Contrary to some previous findings, cumulative 12-month major adverse cardiac events (MACE) are not higher in elderly females compared to elderly males following PPCI.
• PPCI demonstrates significant benefit for elderly STEMI patients, irrespective of sex, with favorable long-term outcomes observed in females.