Naslov
Factors associated with worse outcomes in patients with acute ST segment elevation myocardial infarction: experience in sex differences from the Croatian Branch of the ISACS-CT Registry

Autori
Lončarić, Filip ; Fabijanović, Dora ; Jakuš, Nina ; Mjehović, Petra ; Sabljak, Dorja ; Mišković, Antonija ; Oroz, Dominik ; Čikeš, Maja ; Miličić, Davor

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, prošireni sažetak, znanstveni

Skup
5th Cardiology Highlights − the ESC Update Meeting

Mjesto i datum
Dubrovnik, Hrvatska, 19.10.2017. - 22.10.2017

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
acute coronary syndrome, ISACS-CT, gender differences, ST segment elevation acute myocardial infarction

Sažetak
Background: Women have poorer outcomes in acute coronary syndrome (ACS) due to older age, comorbidities, atypical presentation and delay in admission.1 The aim is to consider gender differences in outcomes in the Croatian Branch of the ISACS-CT registry. Methods: From January 2012 to February 2017, 1808 patients were enrolled in the Croatian branch of the registry, 46% (n=844) presenting with acute ST segment elevation acute myocardial infarction (STEMI), 35% (n=637) with non-ST segment elevation myocardial infarction (NSTEMI) and 18% (n=327) with unstable angina. Sex ratio, male to female, was 2.2:1, the median age 65 (57-75) years. In-hospital mortality was defined as the primary outcome. Results: There was no sex difference in type of ACS at admission. Women were significantly older, generally more burdened with comorbidities and arrived to the hospital with more delay from symptom onset (women vs. men: in the first 2 h - 19% vs. 24%, p=0.02 ; in the first 6 h - 49% vs. 58%, p<0.01) (Figure 2). There was no gender difference in undergoing percutaneous coronary intervention (PCI), but successful revascularization was less often achieved in women (92% vs. 97%, p<0.01). Moreover, female sex (OR = 4.7, CI 95% 1.5-14.7, p=0.021), together with creatinine levels (OR=1.01) and GB IIB/IIIA administration (OR=2.7), proved independently associated with in-hospital mortality in the PCI group, whereas this effect was not seen in the non-invasive treatment group. Conclusion: Gender differences in patients presenting with STEMI are visible in the Croatian branch of the ISACS-CT registry. In this setting, female sex bears risk of worse outcome associated with delay in admission and invasive treatment.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA