Does gender affect the clinical outcome of patients with acute myocardial infarction complicated by cardiogenic shock who undergo percutaneous coronary intervention?

This study sought to determine the impact of female gender on clinical outcome in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) due to predominant ventricular failure undergoing percutaneous coronary intervention (PCI). We analyzed gender‐related differences in procedural, angiographic, and clinical outcomes in 208 consecutive patients with AMI complicated by CS. Out of 208 patients with CS, 65 were women and 143 men. Women were older than men (74 ± 10 years vs. 66 ± 12 years; P < 0.001) and had a greater incidence of a history of hypertension (43% vs. 29%; P = 0.041). The 6‐month mortality rate was 42% in women and 31% in men (P = 0.157). There were no differences between groups in reinfarction rate and target vessel revascularization rate. Multivariate analysis showed age as the only variable independently related to the 6‐month mortality, while female gender was not related to the risk of death. The benefit of early PCI is similar in women and men, and any potential referral bias in the use of PCI based on gender differences should be avoided. Cathet Cardiovasc Intervent 2003;59:423–428. © 2003 Wiley‐Liss, Inc.

[1]  David Antoniucci,et al.  Relation of time to treatment and mortality in patients with acute myocardial infarction undergoing primary coronary angioplasty. , 2002, The American journal of cardiology.

[2]  A. Jacobs,et al.  Absence of gender differences in clinical outcomes in patients with cardiogenic shock complicating acute myocardial infarction. A report from the SHOCK Trial Registry. , 2001, Journal of the American College of Cardiology.

[3]  D. Antoniucci,et al.  Sex-based differences in clinical and angiographic outcomes after primary angioplasty or stenting for acute myocardial infarction. , 2001, The American journal of cardiology.

[4]  D. Brown,et al.  Effect of early revascularization on mortality from cardiogenic shock complicating acute myocardial infarction in California. , 2000, The American journal of cardiology.

[5]  H. S,et al.  Early Revascularization in Acute Myocardial Infarction Complicated by Cardiogenic Shock , 2000 .

[6]  Bruce R. Brodie,et al.  Coronary Angioplasty with or without Stent Implantation for Acute Myocardial Infarction , 1999 .

[7]  J. Delcán,et al.  Efficacy of invasive strategy for the management of acute myocardial infarction complicated by cardiogenic shock. , 1999, The American journal of cardiology.

[8]  Yuan Zhang,et al.  Use of reperfusion therapy for acute myocardial infarction in the United States: data from the National Registry of Myocardial Infarction 2. , 1998, Circulation.

[9]  V. Boddi,et al.  Restenosis after coronary stenting in current clinical practice. , 1998, American heart journal.

[10]  D. Antoniucci,et al.  Systematic direct angioplasty and stent-supported direct angioplasty therapy for cardiogenic shock complicating acute myocardial infarction: in-hospital and long-term survival. , 1998, Journal of the American College of Cardiology.

[11]  P. Kudenchuk,et al.  Association of gender and survival in patients with acute myocardial infarction. , 1997, Archives of internal medicine.

[12]  S. Fortmann,et al.  Differences in treatment of acute myocardial infarction by sex, age, and other factors (the Stanford Five-City Project). , 1996, The American journal of cardiology.

[13]  J Col,et al.  Predictors of 30-day mortality in the era of reperfusion for acute myocardial infarction. Results from an international trial of 41,021 patients. GUSTO-I Investigators. , 1995, Circulation.

[14]  A. Jacobs,et al.  Current Spectrum of Cardiogenic Shock and Effect of Early Revascularization on Mortality Results of an International Registry , 1995 .

[15]  E. Braunwald,et al.  Comparison of Clinical Outcomes for Women and Men after Acute Myocardial Infarction , 1994, Annals of Internal Medicine.

[16]  K. Lee,et al.  Thrombolytic therapy for women with myocardial infarction: is there a gender gap? Thrombolysis and Angioplasty in Myocardial Infarction Study Group. , 1993, Journal of the American College of Cardiology.

[17]  M. Cohen,et al.  Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. , 1985, Journal of the American College of Cardiology.

[18]  H. S. Mueller,et al.  The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. , 1985, The New England journal of medicine.