An Asian perspective on gender differences in in-hospital and long-term outcome of cardiac mortality and ischemic stroke after primary percutaneous coronary …
JN Ngiam, EH Thong, PH Loh, KH Chan… - Journal of Stroke and …, 2022 - Elsevier
Journal of Stroke and Cerebrovascular Diseases, 2022•Elsevier
Objectives Gender differences historically exist in cardiovascular disease, with women
experiencing higher rates of major adverse cardiovascular events. We investigated these
trends in a contemporary Asian cohort, examining the impact of gender differences on
cardiac mortality and ischemic stroke after primary percutaneous coronary intervention
(PPCI) for ST elevation myocardial infarction (STEMI). Materials and Methods We analysed
3971 consecutive patients who underwent primary PCI for STEMI retrospectively. The …
experiencing higher rates of major adverse cardiovascular events. We investigated these
trends in a contemporary Asian cohort, examining the impact of gender differences on
cardiac mortality and ischemic stroke after primary percutaneous coronary intervention
(PPCI) for ST elevation myocardial infarction (STEMI). Materials and Methods We analysed
3971 consecutive patients who underwent primary PCI for STEMI retrospectively. The …
Objectives
Gender differences historically exist in cardiovascular disease, with women experiencing higher rates of major adverse cardiovascular events. We investigated these trends in a contemporary Asian cohort, examining the impact of gender differences on cardiac mortality and ischemic stroke after primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI).
Materials and Methods
We analysed 3971 consecutive patients who underwent primary PCI for STEMI retrospectively. The primary outcome was cardiac mortality and ischemic stroke in-hospital, at one year and on longer-term follow up (median follow up 3.62 years, interquartile range 1.03–6.03 years).
Results
There were 580 (14.6%) female patients and 3391 (85.4%) male patients. Female patients were older and had higher prevalence of hypertension, diabetes, previous strokes, and chronic kidney disease. Cardiac mortality was higher in female patients during in-hospital (15.5% vs. 6.2%), 1-year (17.4% vs. 7.0%) and longer term follow up (19.9% vs. 8.1%, log-rank test: p < 0.001). Similarly, females had higher incidence of ischemic stroke at in-hospital (2.6% vs. 1.0%), 1-year (3.6% vs. 1.4%) and in the longer-term (6.7% vs. 3.1%) as well (log-rank test: p < 0.001). Female gender remained an independent predictor of in-hospital cardiac mortality (HR 1.395, 95%CI 1.061-1.833, p=0.017) and on longer-term follow-up (HR 1.932 95%CI 1.212-3.080, p=0.006) even after adjusting for confounders.
Conclusions
Females were at higher risk of in-hospital and long-term cardiac mortality and ischemic stroke after PPCI for STEMI. Future studies are warranted to investigate the role of aggressive management of cardiovascular risk factors and follow-up to improve outcomes in the females with STEMI.
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