ST-Segment Elevation Myocardial Infarction Differences between Genders - A Single Center Retrospective Analysis.

Area of Science:

• Cardiology
• Interventional Cardiology
• Gender Disparities in Healthcare

Background:

• Outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) have improved.
• However, women consistently demonstrate higher mortality rates compared to men following primary PCI for STEMI.

Purpose of the Study:

• To investigate gender-based differences in the clinical presentation, management strategies, and in-hospital and long-term mortality following STEMI.
• To identify factors contributing to potential disparities in care and outcomes between men and women.

Main Methods:

• A retrospective analysis of 809 consecutive patients treated with primary PCI for STEMI was conducted.
• Data on patient demographics, comorbidities, clinical presentation, treatment, and outcomes were collected and compared between female and male patients.

Main Results:

• Women were older and had a higher prevalence of comorbidities including diabetes, hypertension, and chronic kidney disease.
• Women presented with more atypical symptoms, experienced longer times to reperfusion, and were less likely to receive optimal medical therapy.
• In-hospital, 30-day, 6-month, and 1-year mortality rates were significantly higher in women compared to men.

Conclusions:

• Women with STEMI undergoing primary PCI exhibit a worse risk profile and experience higher mortality rates.
• Systemic delays contributing to longer reperfusion times and suboptimal medical therapy in women may influence outcomes.
• Despite higher mortality, female gender was not identified as an independent prognostic factor for mortality in the multivariate analysis.