Is female gender associated with worse outcome after ST elevation myocardial infarction?

OBJECTIVES: To investigate the impact of gender in outcomes of patients with ST segment myocardial infarction in a setting with limited access to primary percutaneous coronary intervention METHODS: In 1017 consecutive patients hospitalized with ST segment myocardial infarction during years 2008-2013, distribution of risk factors, therapeutic methods, heart failure and in-hospital mortality were compared between males and females. Association of gender and primary outcomes was determined after adjustment for confounding factors.

RESULTS: Females were significantly older (66±12.1years vs. 59.5±12.7years, p<0.001). Prevalence of hypertension, hyperlipidemia and diabetes was significantly higher in females (72.2% vs. 39%, p<0.001, 36.1% vs. 20.3%, p<0.001, 46.5% vs. 32.1%, p<0.001, respectively). Presentation delay was similar in males and females. Females received reperfusion therapy more than males (63.2%vs. 55.8%, p=0.032). Development of heart failure and in-hospital mortality were significantly higher in females (36.5% vs. 27.2%, p=0.003 and 19.4% vs. 12.1%, p=0.002, respectively). However in multivariate analysis, female gender was not independently associated with increased rate of heart failure and in-hospital mortality CONCLUSION: In a center with low rate of primary percutaneous coronary intervention, crude rates of heart failure and in-hospital mortality are higher in females; however, the association is lost after adjustment for baseline characteristics.