Effect of gender on in-hospital mortality in patients with acute ST-elevated myocardial infarction undergoing primary percutaneous coronary intervention

Objective 　To investigate the effect of gender on in-hospital mortality in patients with acute ST-elevated myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Methods 　To retrospectively analyze the data collected from the Management System of Cardiovascular Interventional Treatment in Military Hospitals. A total of 8878 consecutive patients with acute STEMI undergoing PPCI were enrolled, including 7137 males and 1741 females. Data were grouped by gender to evaluate the impact of gender difference on the in-hospital mortality, and the impact was further evaluated by a propensity score analysis to adjust the differences of patients' ages in baseline characteristics between females and males. Results 　Compared with that in male patients, female patients were older (P<0.05), more likely to have hypertension, diabetes, cerebrovascular disease and cardiac dysfunction (P<0.05), but less likely to have history of PCI (P<0.05). The proportions of suffering from triple vessel disease and postoperative hemorrhage were higher in females than in males (P<0.05). Both symptom-onset-to-balloon time and door-to-balloon time were longer in female patients than in male patients (P<0.05). Female patients also presented higher in-hospital mortality (4.4% vs 2.4%, P<0.001). The impact of gender on in-hospital mortality disappeared by a propensity score matching adjusting the differences in baseline characteristics between females and males (Female vs Male: 4.4% vs 4.0%, P=0.610). Multi-logistic regression showed that female was not an independent predictor for in-hospital mortality, while age, cardiac dysfunction, slow blood flow and postoperative hemorrhage were the independent predictors for in-hospital mortality. Conclusion 　Female itself is not an independent predictor for in-hospital mortality in patients with acute STEMI undergoing PPCI. DOI: 10.11855/j.issn.0577-7402.2016.06.03