Sex-based differences in clinical and angiographic outcomes after primary angioplasty or stenting for acute myocardial infraction

A paucity of dam exists on the importance of gender in contributing to the mortality rate after primary angioplasty, although it is has been shown tha t women with acute myocardial infarction (AMI) ore less likely than men to undergo reperfusion treatments. This study analyzes gender-related differen ces in 6-month clinical and angiographic outcomes in nonselected patients w ith AMI who underwent primary angioplasty or stenting. We compared clinical and angiographic outcomes of 230 women and 789 men who underwent primary a ngio-plasty or stenting from January 1995 to August 1999. The women were ol der than the men, and had a greater incidence of diabetes and cardiogenic s hock. The 6-month mortality rate was 12% in women and 7% in men (p = 0.028) . Nonfatal reinfarction occurred in 3% of the women and in 1% of the men (p = 0.010). There were no differences in repeat target vessel revascularizat ion rams. After multivariate analysis, gender did not emerge as a significa nt variable in relation to 6-month mortality or to the combined end point o f death, reinfarction, and repeat target vessel revascularization. Both wom en and men with stented infarct arteries had lower restenosis rates (29% an d 26%, respectively) than patients without stents (52% and 39%, respectivel y). The results of outcome analysis in nonselected patients suggest that se x is not an independent predictor of mortality after primary angioplasty fo r AMI, and that the benefit of primary stenting is similar in men and women . (C) 2001 by Excerpta Medico, Inc.