Edita Piackova1, Bernhard Jäger2, Serdar Farhan3, Günter Christ4, Wolfgang Schreiber5, Franz Weidinger6, Thomas Stefenelli7, Georg Delle-Karth8, Alfred Kaff9, Gerald Maurer10, Kurt Huber2. 1. Wilhelminenhospital, 3rd Medical Department, Cardiology and Intensive Care Medicine, Vienna, Austria. Electronic address: dr.edita.piackova@gmail.com. 2. Wilhelminenhospital, 3rd Medical Department, Cardiology and Intensive Care Medicine, Vienna, Austria; Sigmund Freud Private University, Medical School, Vienna, Austria. 3. Wilhelminenhospital, 3rd Medical Department, Cardiology and Intensive Care Medicine, Vienna, Austria. 4. Sozialmedizinisches Zentrum Süd, 5th Medical Department, Cardiology, Vienna, Austria. 5. Department of Emergency Medicine, University of Medicine, Vienna, Austria. 6. Krankenhaus Rudolfstiftung, 2nd Medical Department, Cardiology, Vienna, Austria. 7. Sozialmedizinisches Zentrum Ost, 1st Medical Department, Cardiology, Vienna, Austria. 8. Krankenhaus Hietzing, 4th Medical Department, Cardiology, Vienna, Austria. 9. Ambulance Services Vienna, Vienna, Austria. 10. Department of Cardiology, Medical University, Vienna, Austria.
Abstract
BACKGROUND: Data obtained from registries have shown that women diagnosed with STEMI are older, have more co-morbidities and a worse clinical outcome than men. Aim of this study was to investigate potential gender differences in in-hospital and long-term mortality in patients from Vienna STEMI registry (2003-2009). PATIENTS AND METHODS: Data from 4593 patients who were enrolled from January 2003 until December 2009 into the Vienna STEMI registry were analyzed. Gender-related differences in patient characteristics, time delays, reperfusion therapy, as well as short- and long-term all-cause mortality were investigated. A landmark analysis was performed to assess long-term all-cause mortality in patients after discharge. Multivariate regression analysis was performed in order to correct for confounders. RESULTS: Mean age, history of hypertension, diabetes mellitus and shock at presentation were significantly higher in women compared to men, whereas men were more frequently smokers, had more frequently a positive family history, a history of previous myocardial infarction and received more often GbIIb/IIIa inhibitors and reperfusion therapy. Overall the only significant difference in time delays was found in the onset of pain-to first medical contact time, which was significantly prolonged in women. Unadjusted in-hospital mortality, long-term mortality and long-term mortality for in-hospital survivors were statistically higher for women. After adjustment for confounders, multivariate analysis revealed no differences in mortalities between males and females. CONCLUSION: The higher risk profile and the prolonged delay between onset of pain-to-first medical contact are responsible for the higher unadjusted mortality rates in women. Difference in short and long-term mortalities is no more existent after statistical correction for confounders such as age, co-morbidities and significantly different time delay.
BACKGROUND: Data obtained from registries have shown that women diagnosed with STEMI are older, have more co-morbidities and a worse clinical outcome than men. Aim of this study was to investigate potential gender differences in in-hospital and long-term mortality in patients from Vienna STEMI registry (2003-2009). PATIENTS AND METHODS: Data from 4593 patients who were enrolled from January 2003 until December 2009 into the Vienna STEMI registry were analyzed. Gender-related differences in patient characteristics, time delays, reperfusion therapy, as well as short- and long-term all-cause mortality were investigated. A landmark analysis was performed to assess long-term all-cause mortality in patients after discharge. Multivariate regression analysis was performed in order to correct for confounders. RESULTS: Mean age, history of hypertension, diabetes mellitus and shock at presentation were significantly higher in women compared to men, whereas men were more frequently smokers, had more frequently a positive family history, a history of previous myocardial infarction and received more often GbIIb/IIIa inhibitors and reperfusion therapy. Overall the only significant difference in time delays was found in the onset of pain-to first medical contact time, which was significantly prolonged in women. Unadjusted in-hospital mortality, long-term mortality and long-term mortality for in-hospital survivors were statistically higher for women. After adjustment for confounders, multivariate analysis revealed no differences in mortalities between males and females. CONCLUSION: The higher risk profile and the prolonged delay between onset of pain-to-first medical contact are responsible for the higher unadjusted mortality rates in women. Difference in short and long-term mortalities is no more existent after statistical correction for confounders such as age, co-morbidities and significantly different time delay.
Authors: Diana N Vikulova; Maja Grubisic; Yinshan Zhao; Kelsey Lynch; Karin H Humphries; Simon N Pimstone; Liam R Brunham Journal: J Am Heart Assoc Date: 2019-07-08 Impact factor: 5.501
Authors: Vu Hoang Tran; Jordy Mehawej; Donna M Abboud; Mayra Tisminetzky; Essa Hariri; Andreas Filippaios; Joel M Gore; Jorge Yarzebski; Jordan H Goldberg; Darleen Lessard; Robert Goldberg Journal: J Am Heart Assoc Date: 2022-08-24 Impact factor: 6.106