• Catheter Cardiovasc Interv · May 2012

    Comparative Study

    Effect of invasive strategy on different genders of Chinese patients with non-ST-elevation myocardial infarction.

    • Shao-Sung Huang, Ying-Hwa Chen, Tse-Min Lu, Tao-Cheng Wu, Min-Ji Charng, Jaw-Wen Chen, Ju-Pin Pan, and Shing-Jong Lin.
    • Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
    • Catheter Cardiovasc Interv. 2012 May 1; 79 (6): 946-55.

    ObjectivesThe aim of this study was to determine the impact of in-hospital revascularization on different genders and to compare the gender difference in short- and long-term prognosis of Chinese patients with non-ST-elevation myocardial infarction (NSTEMI).BackgroundThe benefit of invasive strategy between the genders of Asian ethnic populations with NSTEMI remains unclear.MethodsA total of 343 consecutive NSTEMI patients were enrolled, 104 (30%) of them were women. All patients were followed up for at least 3 years or until the occurrence of a major event. The primary end point was all-cause death. The secondary end point was the combined occurrence of death or myocardial (re-)infarction (MI).ResultsThe adjusted in-hospital and long-term clinical outcomes were similar between men and women. However, in-hospital revascularization significantly reduced long-term mortality and composite endpoint in men (P < 0.001), but not in women. After risk stratification by GRACE score, there was favorable effect of invasive strategy in high-risk women. In a multivariate Cox regression analysis, GRACE score (hazard ratio; HR, 1.017; P < 0.001) and in-hospital revascularization (HR, 0.516; P = 0.008) were the independent predictors of death or MI in men. However, only GRACE score was the independent predictor of composite endpoint in women (HR, 1.012; P = 0.004).ConclusionsIn Asian ethnic patients with NSTEMI, the in-hospital and long-term prognosis were similar between men and women. In-hospital revascularization has a benefit in men and high-risk women for reducing the all-cause death at 1 and 3 years. Our data provide evidence supporting the guideline recommendation for an invasive strategy in high-risk women.Copyright © 2011 Wiley-Liss, Inc.

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