Abstract 4319: Females Have a Higher Rate of Mortality After Primary PCI
Background Women are less likely to receive acute reperfusion treatment for STEMI in clinical practice. Little data exist on gender differences in adjunctive treatment and outcome in the setting of primary PCI in Europe. We examined the impact of female gender on hospital outcome of primary PCI in patients with STEMI in clinical practice in the UK.
Methods From January 2004 to December 2007, 1,163 consecutive patients undergoing primary PCI at a London tertiary referral centre were included. Clinical information was prospectively collected onto a database at the time of the procedure and outcome assessed by all-cause mortality provided by the Office of National Statistics.
Results Female patients (24%) were (8 years) older than males. There were similar incidences of diabetes (19% vs 15%), previous MI (11% vs 13%), and previous CABG (1.1% vs 1.5%). Despite the older age no differences in the degree of coronary artery disease were observed. Adjunctive medical treatment including GPIIb/IIIa blocker was similar in women and men. There was similar in hospital mortality between the groups at discharge (1% vs 0.8%), however from 60 days there is a significantly higher mortality in the female group. This difference persists up to the 5 year post MI (13.5% vs 7.5%, P=0.002) (figure 1⇓). The sex difference in mortality persisted after age correction using multivariate analysis (p=0.01)
Conclusion Women undergoing primary PCI were significantly older than there male counterparts. There was a significantly higher mortality in the female group despite similar risk factor profiles and degree of coronary artery disease. This difference is still significant when correcting for age.