Sociodemographic determinants of gender disparity in primary percutaneous coronary intervention in Pakistan

Expert Rev Cardiovasc Ther. 2023 Jul-Dec;21(11):895-899. doi: 10.1080/14779072.2023.2277356. Epub 2023 Dec 10.

Abstract

Objectives: This study aims to contribute to the body of literature on gender disparities after acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PPCI).

Methods: We identified all adult patients who had AMI between January 2017, and December 2022 and were in follow-up at our institute. We collected data on PPCI, revascularization strategy, sociodemographic characteristics, and in-hospital complications in the years following the procedure.

Results: A total of 5,872 patients who underwent PCI for AMI were included in the study, out of which 2,058 (35%) were women and 3,814 (65%) were men. Regarding the timing of PCI, female patients had a significantly longer median door-to-balloon time compared to male patients (136 minutes vs 108 minutes, P-value = 0.006). Female patients had a significantly higher rate of in-hospital mortality compared to male patients (5.5% vs 1.2%, P-value = 0.011). Multivariate logistic regression analysis showed that female gender, older age, and lower household income were independent predictors of longer door-to-balloon time.

Conclusion: This study highlights gender disparities in PPCI in Pakistan, with female patients facing longer door-to-balloon times and higher in-hospital mortality rates. The findings suggest the need for targeted interventions to improve the access and quality of care for female patients with AMI.

Keywords: Social disparity; coronary artery disease; female gender; ischemic heart disease; percutaneous coronary intervention.

MeSH terms

  • Adult
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Myocardial Infarction* / epidemiology
  • Myocardial Infarction* / surgery
  • Pakistan / epidemiology
  • Percutaneous Coronary Intervention*
  • Treatment Outcome