Clinical profile and angiographic outcomes of acute myocardial infarction in women treated by primary percutaneous coronary intervention - 09/01/21

Résumé |
Background |
Coronary heart disease has been mainly considered as men disease. However, it is the leading cause of morbidity and mortality in women worldwide.
Aim |
We aimed to determine the clinical profile and angiographic outcomes in women following primary percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI).
Methods |
We included 352 patients admitted for STEMI and managed with PCI. They were enrolled between January 2000 and march 2017 in Cardiology B department of Fattouma Bourguiba university hospital.
Results |
Among 352 patients, 56 were women (15.9%). They were older than men. Mean age was 66.5±10 years versus 58±11 years. Females had higher incidence of hypertension (55.4% vs. 24.7%; P<0.001), diabetes (44.6% vs. 30.4%; P=0.037), and dyslipidemia (12.5% vs. 10.8%; P=0.012). Smoking and history of coronary disease were more prevalent in men (P<0.001 and P=0.024 respectively). Women had longer door to balloon time (P=0.004). Anterior wall myocardial infarction was more represented in women population (62.5% vs. 47.3%; P=0.020), but no significant difference was observed in the incidence of initial or post procedural cardiogenic shock. Women were more likely to have multivessel disease (17.9% vs. 10.8%; P=0.01), initial reduced TIMI flow (78.6% vs. 70.3%; P=0.04), no reflow (21.4% vs. 11%; P=0.033) and per procedural coronary dissection (12.5% vs. 6.8%; P=0.013). In hospital mortality rate was higher in female population (23.2% vs. 9.8%; P=0.005). In multivariate analysis, female sex was not an independent factor of in hospital death.
Conclusion |
STEMI in women remains a serious pathology. Its particularities must be better known and studied in order to optimize management and prognosis.
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Vol 13 - N° 1
P. 18 - janvier 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.