The impact of gender on outcomes of patients with ST elevation myocardial infarction transported for percutaneous coronary intervention: analysis of the PRAGUE-1 and 2 studies

Heart. 2008 Mar;94(3):e5. doi: 10.1136/hrt.2006.110866. Epub 2007 Aug 10.

Abstract

Background: Data comparing survival outcomes for women versus men transported for pPCI were absent.

Objectives: To assess the impact of gender on 30-day mortality of patients with STEMI transported for pPCI.

Methods: The data from the PRAGUE-1 and PRAGUE-2 trials were analysed. Studies compared thrombolysis in the community hospital and pPCI after transportation to cardiocentre. A group of 520 patients treated with thrombolysis, and 530 transported for pPCI, were analysed.

Results: Women were older, with a higher risk profile. They had longer ischaemia time. Mortality of patients treated with TL was significantly higher in women than in men (15% vs 9%, p = 0.043). There was no significant gender difference in mortality in the PCI group (8.2% of women vs 6.2% of men, p = 0.409). Mortality of women treated with on-site TL was nearly twice as high as mortality of women transported for pPCI (p = 0.043). After adjustment in a multivariate model the odds ratio for mortality in women was 0.74 (95% CI 0.26 to 2.05; p = 0.556).

Conclusion: Long-distance transportation of women with STEMI from a community hospital to a tertiary PCI centre is a significantly more effective treatment strategy than on-site TL. Gender did not determine survival in patients transported for pPCI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Angioplasty, Balloon, Coronary / methods*
  • Angioplasty, Balloon, Coronary / mortality
  • Cardiac Catheterization / methods
  • Cardiac Catheterization / mortality
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy*
  • Myocardial Reperfusion / methods
  • Myocardial Reperfusion / mortality
  • Patient Transfer / methods*
  • Randomized Controlled Trials as Topic
  • Sex Factors
  • Thrombolytic Therapy / methods
  • Thrombolytic Therapy / mortality
  • Treatment Outcome