Factors of Hospital Mortality in Men and Women with ST-Elevation Myocardial Infarction - An Observational,
Martin Marinsek1, David Šuran2, Andreja Sinkovic1,3
1Department of Medical Intensive Care, University Clinical Centre Maribor, Maribor, 2000, Slovenia.
Insights
Hospital mortality for ST-elevation myocardial infarction (STEMI) is higher in women than men. Key factors like age and heart failure impact both, but bleeding is more common in women and infection in men.
Area of Science:
- Cardiology
- Clinical Medicine
- Public Health
Background:
- Gender disparities in mortality following ST-elevation myocardial infarction (STEMI) are recognized.
- Factors contributing to these differences in hospital mortality remain less understood.
Purpose of the Study:
- To investigate and compare the factors influencing hospital mortality in men and women diagnosed with STEMI.
- To identify specific risk factors for mortality within each gender group.
Main Methods:
- Retrospective analysis of 485 men and 214 women treated with primary percutaneous coronary intervention (PCI) for STEMI between 2018-2019.
- Comparison of baseline characteristics, treatments, and in-hospital complications between genders and survival groups.
Main Results:
- In-hospital mortality was significantly higher in women (14%) compared to men (8%) with STEMI (p=0.019).
- Common mortality factors included older age, heart failure, prior resuscitation, and acute kidney injury.
- Less successful primary PCI was associated with higher mortality in both genders.
- Specific factors included hospital infection in men and bleeding in women.
- Mortality rates were similar between men and women aged ≥65 years.
Conclusions:
- While many factors for hospital mortality in STEMI patients are shared between genders, specific complications like bleeding in women and infection in men are notable.
- These findings highlight the need for gender-specific considerations in STEMI management.
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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