Introducere: Myocardial infarction (MI) represents a major public health problem. Despite the mortality rate decreased considerably over the years, many studies suggest significant differences in evolution and survival after ST-elevation myocardial infarction (STEMI) between the genders.
Objective: To evaluate gender differences in-hospital evolution after STEMI and to identify the substrate of these differences.
Methods: Data regarding patients age, gender, medi-cal history, cardiovascular risk factors, clinical, he-modynamic, electrocardiographyc (ECG), echocardio-graphic, angiographic status and blood parameters at hospital admission were retrospectively assessed from 672 patiens with STEMI who underwent primary per-cutaneous coronary intervention (pPCI). Arrhythmic, hemodynamic complications and in-hospital mortality were also evaluated for each patient. A comparative analysis between female and male patients was performed.
Results: Of the 672 patiens, 204 (30.4%) were females. Similar rates of arrhythmic complication were found in both men and women (all the p values >0.05), but a hi-gher percentage of female patiens developed cardiogen shock (12.7% vs. 6.6%, p=0.01) and more frequently required intropic agents (17.6% vs. 11.9%, p=0.04) and diuretic treatment (38.7% vs. 25.6%, p<0.001). In-hospital mortality was higher for females (RR 1.76 [IC95% 1.27-2.45], p<0.01). There was no differences between males and females regarding Killip class, ECG, echocardiographic, angiographic status (all p- values >0.05), but females were older (66±11 vs. 59±12 years, p<0.001),were more frequently hypertensive (70.5% vs. 61.7%, p=0,02), diabetics (31.3% vs. 18.1%, p<0.01), with medical history of congestive heart failure (16.1% vs. 6.1%, p<0.001), with longer time of presentation (6 [4-9] vs. 5 [3-7] hours, p<0.01). However after correc-tion factors, female gender was not found to be an in-dependent predictor for in-hospital mortality (p=0.12).
Conclusions: Despite females represented less than a third of STEMI patients underwent pPCI, these pre-sented more frequently complication and had higher in-hospital mortality. These differences could be en-tirely explained by higher cardiovascular risk factors burden in females, while the female gender per se was not identified to affect the prognostic impact immedi-ately after STEMI.