Abstract 18048: Short and Long Term Mortality in Women and Men Undergoing Primary Angioplasty: a Comprehensive Meta-analysis
Introduction: Women with acute myocardial infarction are treated less aggressively than men and have a higher mortality. It is possible that the reported differences in outcome by sex are a result of differences in baseline risk and hospital management. We hypothesized that mortality would be similar among a cohort of women and men receiving guideline recommended reperfusion therapy for STEMI with primary PCI.
Methods: We performed a meta-analysis of studies of patients with STEMI referred for primary PCI. PubMed, EMBASE and Scopus databases were searched. Studies reporting 30-day and long-term gender specific crude mortality rates and or adjusted effect estimates in STEMI patients undergoing PCI were identified. Pooled effect estimates were calculated with random effects models.
Results: A total of 33 studies, involving 67,875 patients, (17,093 women and 50,782 men) were included in the analysis. As compared to men, women were older, had higher prevalence of hypertension, diabetes, hyperlipidemia, Killip >1/heart failure and had lower use of aspirin, plavix and statins on discharge (p<0.001 for all).Using crude rates from individual studies, women had significantly higher 30-day mortality [pooled relative risk (RR): 1.79 (1.51 -2.11), p<0.001; 20 studies (n=42,749)] and long-term mortality [RR: 1.58 (1.44 -1.74), p<0.001; 25 studies (n=50,552)]. When meta-analysis using multi-variable adjusted RR from individual studies was performed, 30-day mortality [RR: 1.15 (0.97 - 1.37), p =0.11; 11 studies (n=23,805)] and long-term mortality [RR: 1.02 (0.95 -1.10), p =0.58; 19 studies (n=51,124)] were no longer significantly different between women and men.
Conclusions: Among STEMI patients undergoing primary PCI, short and long term mortality risk is similar in women and men after adjusting for other confounding variables. This reinforces the importance of providing evidence based reperfusion therapy to eligible women and men with acute STEMI.
Author Disclosures: C. Bavishi: None. D. Patel: None. S. Chatterjee: None. V. Trivedi: None. A. Sawant: None. J.E. Tamis-Holland: None.
- © 2014 by American Heart Association, Inc.