PMID- 21167341
OWN - NLM
STAT- MEDLINE
DCOM- 20110223
LR  - 20101220
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 161
IP  - 1
DP  - 2011 Jan
TI  - The association of sex with outcomes among patients undergoing primary 
      percutaneous coronary intervention for ST elevation myocardial infarction in the 
      contemporary era: Insights from the Blue Cross Blue Shield of Michigan 
      Cardiovascular Consortium (BMC2).
PG  - 106-112.e1
LID - 10.1016/j.ahj.2010.09.030 [doi]
AB  - BACKGROUND: historically, women with ST elevation myocardial infarction (STEMI) 
      have had a higher mortality compared with men. It is unclear if these differences 
      persist among patients undergoing contemporary primary percutaneous coronary 
      intervention (PCI) with focus on early reperfusion. METHODS: we assessed the 
      impact of sex on the outcome of 8,771 patients with acute STEMI who underwent 
      primary PCI from 2003 to 2008 at 32 hospitals participating in the Blue Cross 
      Blue Shield of Michigan Cardiovascular Consortium PCI registry. A 
      propensity-matched analysis was performed to adjust for differences in baseline 
      characteristics and comorbidities between men and women. RESULTS: twenty-nine 
      percent of the cohort was female. Compared with men, women were older and had 
      more comorbidity. Female sex was associated with a higher unadjusted in-hospital 
      mortality (6.02% vs 3.45%, odds ratio [OR] 1.79, 95% CI 1.45-2.22, P < .0001) and 
      higher risk of contrast-induced nephropathy (OR 1.75, P < .0001), vascular 
      complications (OR 2.13, P < .0001), and postprocedure transfusion (OR 2.84, P < 
      .0001). The gap in sex-specific mortality narrowed over time. In a 
      propensity-matched analysis, female sex was associated with a higher rate of 
      transfusion (OR 1.88, 95% CI 1.57-2.24, P < .0001) and vascular complications (OR 
      1.65, 95% CI 1.26-2.14, P < .0002); but there was no difference in mortality (OR 
      1.30, 95% CI 0.98-1.72, P = .07). CONCLUSIONS: women make up approximately one 
      third of patients undergoing primary PCI for STEMI. Female sex is associated with 
      an apparent hazard of increased mortality among patients undergoing primary PCI 
      for STEMI, but this difference is likely explained by older age and worse 
      baseline comorbidities among women.
FAU - Jackson, Elizabeth A
AU  - Jackson EA
AD  - Department of Internal Medicine, Division of Cardiovascular Medicine, The 
      University of Michigan, Ann Arbor, MI, USA.
FAU - Moscucci, Mauro
AU  - Moscucci M
FAU - Smith, Dean E
AU  - Smith DE
FAU - Share, David
AU  - Share D
FAU - Dixon, Simon
AU  - Dixon S
FAU - Greenbaum, Adam
AU  - Greenbaum A
FAU - Grossman, Paul M
AU  - Grossman PM
FAU - Gurm, Hitinder S
AU  - Gurm HS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - *Electrocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Male
MH  - Michigan/epidemiology
MH  - Middle Aged
MH  - Myocardial Infarction/epidemiology/physiopathology/*therapy
MH  - Prospective Studies
MH  - *Registries
MH  - Risk Factors
MH  - Sex Distribution
MH  - Sex Factors
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2010/12/21 06:00
MHDA- 2011/02/24 06:00
CRDT- 2010/12/21 06:00
PHST- 2010/06/30 00:00 [received]
PHST- 2010/09/23 00:00 [accepted]
PHST- 2010/12/21 06:00 [entrez]
PHST- 2010/12/21 06:00 [pubmed]
PHST- 2011/02/24 06:00 [medline]
AID - S0002-8703(10)00901-4 [pii]
AID - 10.1016/j.ahj.2010.09.030 [doi]
PST - ppublish
SO  - Am Heart J. 2011 Jan;161(1):106-112.e1. doi: 10.1016/j.ahj.2010.09.030.