Absence of gender disparity in short-term clinical outcomes in patients with acute ST-segment elevation myocardial infarction undergoing sirolimus-eluting stent based primary coronary intervention: a report from Shanghai Acute Coronary Event (SACE) Registry

作者：Zhang Qi; Qiu Jian-ping; Zhang Rui-yan; Li Yi-gang; He Ben; Jin Hui-gen; Zhang Jun-feng; Wang Xiao-long; Jiang Li; Liao Min-lei; Hu Jian; Shen Wei-feng^*

来源：Chinese Medical Journal, 2010, 123(7): 782-788.

DOI：10.3760/cma.j.issn.0366-6999.2010.07.004

• acute myocardial infarction
• gender
• angioplasty
• stent
• prognosis

Background Randomized, controlled trials have demonstrated the superiority of sirolimus-eluting stent (SES) implantation during primary percutaneous coronary intervention (PCI), as opposed to bare-metal stents, in patients with ST-elevation myocardial infarction (STEM!). This study aimed to test the hypothesis that clinical benefits of SES treatment were independent of gender in this setting. @@@ Methods A total of 2042 patients with STEMI undergoing SES-based primary PCI were prospectively enrolled into Shanghai Acute Coronary Event (SACE) registry (1574 men and 468 women). Baseline demographics, angiographic and PCI features, and in-hospital and 30-day major adverse cardiac events (MACE) were analyzed as a function of gender. @@@ Results Compared with men, women were older and more frequently had hypertension, diabetes, and hypercholesterolemia. Use of platelet glycoprotein IIb/IIIa receptor inhibitor (GPI, 65.5% vs. 62.2%, P=0.10) and procedural success rate (95.0% vs. 94.2%, P=0.52) were similar in both genders. In-hospital death and MACE occurred in 3.8% and 7.6%, and 4.5% and 8.1% in the male and female patients, respectively (all P >0.05). At 30-day follow-up, survival (94.3% vs. 93.8%, P=0.66) and MACE-free survival (90.2% vs. 89.3%, P=0.52) did not significantly differ between men and women. After adjustment for differences in patient demographics, angiographic and procedural features, there were no significant difference in either in-hospital (OR=0.77, 95%CI of 0.48 to 1.22, P=0.30) or 30-day mortality (OR=1.28, 95%CI of 0.73 to 2.23, P=0.38) between women and men. @@@ Conclusion Despite more advanced age and clustering of risk factors in women, female patients with STEMI treated by SES-based primary PCI had similar in-hospital and short-term clinical outcomes as their male counterparts. Chin Med J 2010;123(7):782-788

• 出版日期2010-4-5
• 单位上海市闵行区中心医院; 上海市同仁医院; 上海市浦东新区公利医院; 上海交通大学; 上海中医药大学