• Medicina intensiva · Sep 2016

    Gender gap in medical care in ST segment elevation myocardial infarction networks: Findings from the Catalan network Codi Infart.

    • D Fernández-Rodríguez, A Regueiro, J Cevallos, X Bosch, X Freixa, M Trilla, S Brugaletta, V Martín-Yuste, M Sabaté, F Bosa-Ojeda, M Masotti, and en representación de los investigadores del Registro Codi Infart.
    • Servicio de Cardiología, Hospital Clínic, Universidad de Barcelona, Barcelona, España; Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, España.
    • Med Intensiva. 2016 Sep 27.

    ObjectiveTo assess the impact of gender upon the prognosis and medical care in a regional acute ST-elevation myocardial infarction management network.DesignAn observational study was made of consecutive patients entered in a prospective database.ScopeThe Catalan acute ST-elevation myocardial infarction management network.PatientsPatients treated between January 2010 and December 2011.InterventionsPrimary angioplasty, thrombolysis or conservative management.Variables Of InterestTime intervals, proportion and type of reperfusion, overall mortality, and in-hospital complication and overall mortality at 30 days and one year were compared in relation to gender.ResultsOf the 5,831 patients attended by the myocardial infarction network, 4,380 had a diagnosis of acute ST-elevation myocardial infarction, and 961 (21.9%) were women. Women were older (69.8±13.4 vs. 60.6±12.8 years; P<.001), had a higher prevalence of diabetes (27.1 vs. 18.1%, P<.001), Killip class>I (24.9 vs. 17.3%; P<.001) and no reperfusion (8.8 vs. 5.2%; P<.001) versus men. In addition, women had greater delays in medical care (first medical contact-to-balloon: 132 vs. 122min; P<.001, and symptoms onset-to-balloon: 236 vs. 210min; P<.001). Women presented higher percentages of overall in-hospital complications (20.6 vs. 17.4%; P=.031), in-hospital mortality (4.8 vs. 2.6%; P=.001), 30-day mortality (9.1 vs. 4.5%; P<.001) and one-year mortality (14.0 vs. 8.3%; P<.001) versus men. Nevertheless, after multivariate adjustment, no gender differences in 30-day and one-year mortality were observed.ConclusionsDespite a higher risk profile and poorer medical management, women present similar 30-day and one-year outcomes as their male counterparts in the context of the myocardial infarction management network.Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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