Victoria B Milan, Yasmin F S Alves, Guilherme P Machado, Gustavo Neves de Araujo, Ana Maria Krepsky, Angelo Chies, Matheus Niches, Julia Fracasso, Sandro Cadaval Goncalves, Marco Wainstein, Carisi Anne Polanczyk
{"title":"接受初次经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者结局的性别差异。","authors":"Victoria B Milan, Yasmin F S Alves, Guilherme P Machado, Gustavo Neves de Araujo, Ana Maria Krepsky, Angelo Chies, Matheus Niches, Julia Fracasso, Sandro Cadaval Goncalves, Marco Wainstein, Carisi Anne Polanczyk","doi":"10.36660/abc.20220673","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Several studies have shown that women are usually undertreated and have worse outcomes after ST-segment elevation myocardial infarction (STEMI), hence the need to investigate questions related to sex in Brazil to better deal with the problem.</p><p><strong>Objective: </strong>To determine whether female sex is still associated with adverse events in a contemporary cohort of patients with STEMI undergoing primary percutaneous coronary intervention (pPCI).</p><p><strong>Methods: </strong>This was a prospective cohort study of STEMI patients submitted to pPCI in a tertiary university hospital between March 2011 and December 2021. Patients were categorized into groups based on their sex at birth. The primary clinical outcome was long-term MACCE. Patients were followed-up for up to five years. All hypothesis tests had a two-sided significance level of 0.05.</p><p><strong>Results: </strong>Among 1457 patients admitted with STEMI in the study period, 1362 were included and 468 (34.4%) were women. Female patients had a higher prevalence of hypertension (73% vs. 60%, p <0.001), diabetes (32% vs. 25%, p=0.003) and Killip class 3-4 at hospital admission (17% vs. 12%, p=0.01); TIMI risk score was higher among women (4 [2, 6] vs. 3 [2, 5], p<0.001). In-hospital mortality was not different between groups (12.8% vs. 10.5%, p=0.20). In-hospital MACCE (16.0% vs. 12.6%, p=0.085) and long-term MACCE (28.7% vs. 24.4%, p=0.089) were numerically higher in women, with borderline significance. After multivariate analysis, female sex was not associated with MACCE (HR = 1.14; 95% CI 0.86 - 1.51; p = 0.36).</p><p><strong>Conclusion: </strong>In a prospective cohort of STEMI patients submitted to pPCI, female patients were older and had more comorbidities at baseline, but no significant differences were found in terms of long-term adverse outcomes.</p>","PeriodicalId":8399,"journal":{"name":"Arquivos Brasileiros de Cardiologia","volume":"120 6","pages":"e20220673"},"PeriodicalIF":2.0000,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263405/pdf/","citationCount":"0","resultStr":"{\"title\":\"Sex Differences in Outcomes of ST Elevation Myocardial Infarction Patients Submitted to Primary Percutaneous Coronary Intervention.\",\"authors\":\"Victoria B Milan, Yasmin F S Alves, Guilherme P Machado, Gustavo Neves de Araujo, Ana Maria Krepsky, Angelo Chies, Matheus Niches, Julia Fracasso, Sandro Cadaval Goncalves, Marco Wainstein, Carisi Anne Polanczyk\",\"doi\":\"10.36660/abc.20220673\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Several studies have shown that women are usually undertreated and have worse outcomes after ST-segment elevation myocardial infarction (STEMI), hence the need to investigate questions related to sex in Brazil to better deal with the problem.</p><p><strong>Objective: </strong>To determine whether female sex is still associated with adverse events in a contemporary cohort of patients with STEMI undergoing primary percutaneous coronary intervention (pPCI).</p><p><strong>Methods: </strong>This was a prospective cohort study of STEMI patients submitted to pPCI in a tertiary university hospital between March 2011 and December 2021. Patients were categorized into groups based on their sex at birth. The primary clinical outcome was long-term MACCE. Patients were followed-up for up to five years. All hypothesis tests had a two-sided significance level of 0.05.</p><p><strong>Results: </strong>Among 1457 patients admitted with STEMI in the study period, 1362 were included and 468 (34.4%) were women. Female patients had a higher prevalence of hypertension (73% vs. 60%, p <0.001), diabetes (32% vs. 25%, p=0.003) and Killip class 3-4 at hospital admission (17% vs. 12%, p=0.01); TIMI risk score was higher among women (4 [2, 6] vs. 3 [2, 5], p<0.001). In-hospital mortality was not different between groups (12.8% vs. 10.5%, p=0.20). In-hospital MACCE (16.0% vs. 12.6%, p=0.085) and long-term MACCE (28.7% vs. 24.4%, p=0.089) were numerically higher in women, with borderline significance. After multivariate analysis, female sex was not associated with MACCE (HR = 1.14; 95% CI 0.86 - 1.51; p = 0.36).</p><p><strong>Conclusion: </strong>In a prospective cohort of STEMI patients submitted to pPCI, female patients were older and had more comorbidities at baseline, but no significant differences were found in terms of long-term adverse outcomes.</p>\",\"PeriodicalId\":8399,\"journal\":{\"name\":\"Arquivos Brasileiros de Cardiologia\",\"volume\":\"120 6\",\"pages\":\"e20220673\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2023-06-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263405/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arquivos Brasileiros de Cardiologia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.36660/abc.20220673\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arquivos Brasileiros de Cardiologia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.36660/abc.20220673","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Sex Differences in Outcomes of ST Elevation Myocardial Infarction Patients Submitted to Primary Percutaneous Coronary Intervention.
Background: Several studies have shown that women are usually undertreated and have worse outcomes after ST-segment elevation myocardial infarction (STEMI), hence the need to investigate questions related to sex in Brazil to better deal with the problem.
Objective: To determine whether female sex is still associated with adverse events in a contemporary cohort of patients with STEMI undergoing primary percutaneous coronary intervention (pPCI).
Methods: This was a prospective cohort study of STEMI patients submitted to pPCI in a tertiary university hospital between March 2011 and December 2021. Patients were categorized into groups based on their sex at birth. The primary clinical outcome was long-term MACCE. Patients were followed-up for up to five years. All hypothesis tests had a two-sided significance level of 0.05.
Results: Among 1457 patients admitted with STEMI in the study period, 1362 were included and 468 (34.4%) were women. Female patients had a higher prevalence of hypertension (73% vs. 60%, p <0.001), diabetes (32% vs. 25%, p=0.003) and Killip class 3-4 at hospital admission (17% vs. 12%, p=0.01); TIMI risk score was higher among women (4 [2, 6] vs. 3 [2, 5], p<0.001). In-hospital mortality was not different between groups (12.8% vs. 10.5%, p=0.20). In-hospital MACCE (16.0% vs. 12.6%, p=0.085) and long-term MACCE (28.7% vs. 24.4%, p=0.089) were numerically higher in women, with borderline significance. After multivariate analysis, female sex was not associated with MACCE (HR = 1.14; 95% CI 0.86 - 1.51; p = 0.36).
Conclusion: In a prospective cohort of STEMI patients submitted to pPCI, female patients were older and had more comorbidities at baseline, but no significant differences were found in terms of long-term adverse outcomes.
期刊介绍：
With more than 70 years of existence, Arquivos Brasileiros de Cardiologia is the main channel for the dissemination of Brazilian scientific research on cardiovascular sciences. Published in two languages and indexed in major international databases, all scientific contributions are peer-reviewed and reviewed by editorial board members selected among the most reputable researchers in Brazil and abroad. The manuscripts are reviewed according to their relevance and originality, scientific accuracy and level of importance for the advancement of science. With an average time of nine months between the initial submission and the effective publication of the manuscripts, and less than seven months until they are published on PubMed, Arquivos Brasileiros de Cardiologia can ensure the quick inclusion of the researchers’ papers in the international literature.
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