Worse outcome in women with STEMI: a systematic review of prognostic studies
Manon G. van der Meer
Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
Search for more papers by this authorHendrik M. Nathoe
Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
Search for more papers by this authorYolanda van der Graaf
Julius Centre (Epidemiology), University Medical Centre Utrecht, Utrecht, the Netherlands
Search for more papers by this authorPieter A. Doevendans
Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
Search for more papers by this authorCorresponding Author
Yolande Appelman
Department of Cardiology, VU University Medical Centre Amsterdam, Amsterdam, the Netherlands
Correspondence to: Yolande Appelman, Department of Invasive Cardiology, VU University Medical Centre Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
Tel.: 0031204442244; fax: 0204444645; e-mail: [email protected]
Search for more papers by this authorManon G. van der Meer
Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
Search for more papers by this authorHendrik M. Nathoe
Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
Search for more papers by this authorYolanda van der Graaf
Julius Centre (Epidemiology), University Medical Centre Utrecht, Utrecht, the Netherlands
Search for more papers by this authorPieter A. Doevendans
Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands
Search for more papers by this authorCorresponding Author
Yolande Appelman
Department of Cardiology, VU University Medical Centre Amsterdam, Amsterdam, the Netherlands
Correspondence to: Yolande Appelman, Department of Invasive Cardiology, VU University Medical Centre Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
Tel.: 0031204442244; fax: 0204444645; e-mail: [email protected]
Search for more papers by this authorAbstract
Background
Treatment of ST elevation myocardial infarction (STEMI) has improved enormously since the introduction of primary percutaneous coronary intervention (pPCI). It remains unclear whether differences in survival between women and men treated with pPCI exist and whether these potential differences can be explained by gender or by differences in baseline- or procedural characteristics. Therefore we systematically reviewed the available evidence.
Materials and methods
On 10 May 2013 PubMed, Embase and Cochrane were searched for studies comprising original data on STEMI patients treated with pPCI. A separate gender analysis including > 100 women was a requirement. Data were extracted and pooled whenever possible.
Results
21 studies were included from 2001 to 2013 comprising 47·439 men and 16·927 women. Women were older, had more diabetes (women 24%, men 15%) and hypertension (women 58%, men 45%), and were less current smokers (women 30%, men 54%). The procedural characteristics were comparable except for a longer symptom-to-balloon time (women 266 min, men 240 min) and less use of GP IIb/IIIa inhibitors in women (women 51%, men 57%). Crude short- and long-term mortality was higher in women. Although we could not pool adjusted mortality proportions due to heterogeneity, generally the difference in mortality disappeared after adjustment for baseline- and procedural characteristics.
Conclusion
Mortality is higher in women with STEMI and can be explained by their unfavourable risk profile and longer symptom-to-balloon time.
Supporting Information
| Filename | Description |
|---|---|
| eci12399-sup-0001-TableS1-S6.docxWord document, 80.8 KB | Table S1. Search string. Table S2. Quality assessment. Table S3. In-hospital mortality. Table S4. 30 days mortality. Table S5. One-year mortality. Table S6. Long-term mortality. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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