TY - JOUR
T1 - Complicaciones y mortalidad a 30 días y al año en pacientes con primer IAMCEST tratados en la red Codi IAM en 2010-2016
T2 - análisis del efecto del género
AU - Tizón-Marcos, Helena
AU - Vaquerizo, Beatriz
AU - Marrugat, Jaume
AU - Ariza, Albert
AU - Carrillo, Xavier
AU - Muñoz, Juan Francisco
AU - Cárdenas, Mérida
AU - García-Picart, Joan
AU - Rojas, Sergio Giovanni
AU - Tomás-Querol, Carlos
AU - Massotti, Mònica
AU - Lidón, Rosa Maria
AU - Jiménez, Josep
AU - Martí-Almor, Julio
AU - Farré, Núria
AU - Pérez-Fernández, Sílvia
AU - Curós, Antoni
AU - Mauri Ferré, Josepa
PY - 2020
Y1 - 2020
N2 - Introduction and objectives: ST-segment elevation myocardial infarction (STEMI) emergency care networks aim to increase reperfusion rates and reduce ischemic times. The influence of sex on prognosis is still being debated. Our objective was to analyze prognosis according to sex after a first STEMI. Methods: This multicenter cohort study enrolled first STEMI patients from 2010 to 2016 to determine the influence of sex after adjustment for revascularization delays, age, and comorbidities. End points were 30-day mortality, the 30-day composite of mortality, ventricular fibrillation, pulmonary edema, or cardiogenic shock, and 1-year all-cause mortality. Results: From 2010 to 2016, 14 690 patients were included; 24% were women. The median [interquartile range] time from electrocardiogram to artery opening decreased throughout the study period in both sexes (119 minutes [85-160] vs 109 minutes [80-153] in 2010, 102 minutes [81-133] vs 96 minutes [74-124] in 2016, both P = .001). The rates of primary PCI within 120 minutes increased in the same period (50.4% vs 57.9% and 67.1% vs 72.1%, respectively; both P = .001). After adjustment for confounders, female sex was not associated with 30-day complications (OR, 1.06; 95%CI, 0.91-1.22). However, female 30-day survivors had a lower adjusted 1-year mortality than their male counterparts (HR,0.76; 95%CI, 0.61-0.95). Conclusions: Compared with men, women with a first STEMI had similar 30-day mortality and complication rates but significantly lower 1-year mortality after adjustment for age and severity.
AB - Introduction and objectives: ST-segment elevation myocardial infarction (STEMI) emergency care networks aim to increase reperfusion rates and reduce ischemic times. The influence of sex on prognosis is still being debated. Our objective was to analyze prognosis according to sex after a first STEMI. Methods: This multicenter cohort study enrolled first STEMI patients from 2010 to 2016 to determine the influence of sex after adjustment for revascularization delays, age, and comorbidities. End points were 30-day mortality, the 30-day composite of mortality, ventricular fibrillation, pulmonary edema, or cardiogenic shock, and 1-year all-cause mortality. Results: From 2010 to 2016, 14 690 patients were included; 24% were women. The median [interquartile range] time from electrocardiogram to artery opening decreased throughout the study period in both sexes (119 minutes [85-160] vs 109 minutes [80-153] in 2010, 102 minutes [81-133] vs 96 minutes [74-124] in 2016, both P = .001). The rates of primary PCI within 120 minutes increased in the same period (50.4% vs 57.9% and 67.1% vs 72.1%, respectively; both P = .001). After adjustment for confounders, female sex was not associated with 30-day complications (OR, 1.06; 95%CI, 0.91-1.22). However, female 30-day survivors had a lower adjusted 1-year mortality than their male counterparts (HR,0.76; 95%CI, 0.61-0.95). Conclusions: Compared with men, women with a first STEMI had similar 30-day mortality and complication rates but significantly lower 1-year mortality after adjustment for age and severity.
KW - Female sex
KW - Gender gap
KW - Mortality
KW - Primary percutaneous coronary intervention
KW - Reperfusion
KW - ST-elevation myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=85090155613&partnerID=8YFLogxK
U2 - 10.1016/j.recesp.2020.05.024
DO - 10.1016/j.recesp.2020.05.024
M3 - Artículo
AN - SCOPUS:85090155613
ER -