Objective: To investigate and analyze the impact of gender difference on outcome and prognosis of ST-segment elevation myocardial infarction (STEMI) in patients treated with primary percutaneous coronary intervention (PCI).
Methods: This was a prospective and multicentered observation study. All the patients with acute STEMI admitted to the hospitals from June 1(st) 2009 to June 1(st) 2010 were continuously recruited. In this study, a unified questionnaire was applied and the 382 patients satisfied the criteria. A unified follow-up questionnaire was used on patients who were discharged from the hospital.
Results: On average, the female patients were 8 years older than the males. The median "symptom-to-balloon time" was 312.5 minutes in females and 270.0 minutes in males, and it was significantly different (P = 0.007). During hospitalization, a higher proportion of female patients developed heart failure, angina and bleeding. No gender differences were found on the in-hospital mortality rates and medical therapy recommended by the guideline. The female patients were more prone to multi-vessel disease than males (P = 0.002). Success rates of primary PCI did not show any gender differences. One-month mortality and other cardiovascular events also did not show gender difference when the patients were followed for one month after being discharged. The rates of heart failure and re-hospitalization due to cardiac incidents among female patients were obviously higher than the males, three months after being discharged (P = 0.007, respectively). However, the three-month and long-term cardiac mortality did not show differences related to gender. Female patients were associated with higher all-cause mortality than that in males, but there was no statistically significant difference (female 4.2% vs. male 1.6%; P = 0.056). Data from multi-factor regression analysis showed that being female was not an independent predictor related to in-hospital mortality or during the follow-up period.
Conclusion: Being female was not an independent predictor of in-hospital mortality or during follow-up period among patients who were treated with primary PCI. Worse long-term outcome seen in female patients was likely to be explained by older age or longer pre-hospital delayed time.