Gender-related benefit of transport to primary angioplasty: Is it equal?

Abstract

Background. Infarct size is correlated with duration of coronary artery occlusion. Evidence suggests that transport for primary angioplasty improves outcomes, but there is no agreement regarding differences in prognosis between men and women. We compared outcomes in men and women with ST-segment elevation myocardial infarction (STEMI) transferred from another hospital against those who had been transported directly to an invasive treatment center.
Methods. Data was collected between June 2005 and May 2006 from a registry of 26,035 patients with STEMI and in whom primary angioplasty had been performed.
Results. A total of 10,708 patients underwent primary angioplasty. Of these, 3,359 men and 1,469 women were transported directly, while 4,135 men and 1,745 women were transferred from another site. In-hospital mortality and at one month, six months and 12 months after hospital discharge was significantly higher in women than in men. The prognosis of women transported directly was similar to that of women transferred from another site. However, there was a tendency, albeit insignificant, towards higher mortality at six and 12 months in women transported from another hospital.
Conclusions. To reduce mortality in STEMI, an immediate reperfusion must not be delayed. This conclusion is valid particularly for women who are at greater risk of death. (Cardiol J 2011; 18, 3: 254–260)