PMID- 34814003
OWN - NLM
STAT- MEDLINE
DCOM- 20220204
LR  - 20221207
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Linking)
VI  - 31
IP  - 1
DP  - 2022 Jan
TI  - An Asian Perspective on Gender Differences in In-Hospital and Long-Term Outcome 
      of Cardiac Mortality and Ischemic Stroke after Primary Percutaneous Coronary 
      Intervention for ST-Segment Elevation Myocardial Infarction.
PG  - 106215
LID - S1052-3057(21)00620-0 [pii]
LID - 10.1016/j.jstrokecerebrovasdis.2021.106215 [doi]
AB  - OBJECTIVES: Gender differences historically exist in cardiovascular disease, with 
      women experiencing higher rates of major adverse cardiovascular events. We 
      investigated these trends in a contemporary Asian cohort, examining the impact of 
      gender differences on cardiac mortality and ischemic stroke after primary 
      percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction 
      (STEMI). MATERIALS AND METHODS: We analysed 3971 consecutive patients who 
      underwent primary PCI for STEMI retrospectively. The primary outcome was cardiac 
      mortality and ischemic stroke in-hospital, at one year and on longer-term follow 
      up (median follow up 3.62 years, interquartile range 1.03-6.03 years). RESULTS: 
      There were 580 (14.6%) female patients and 3391 (85.4%) male patients. Female 
      patients were older and had higher prevalence of hypertension, diabetes, previous 
      strokes, and chronic kidney disease. Cardiac mortality was higher in female 
      patients during in-hospital (15.5% vs. 6.2%), 1-year (17.4% vs. 7.0%) and longer 
      term follow up (19.9% vs. 8.1%, log-rank test: p < 0.001). Similarly, females had 
      higher incidence of ischemic stroke at in-hospital (2.6% vs. 1.0%), 1-year (3.6% 
      vs. 1.4%) and in the longer-term (6.7% vs. 3.1%) as well (log-rank test: 
      p < 0.001). Female gender remained an independent predictor of in-hospital 
      cardiac mortality (HR 1.395, 95%CI 1.061-1.833, p=0.017) and on longer-term 
      follow-up (HR 1.932 95%CI 1.212-3.080, p=0.006) even after adjusting for 
      confounders. CONCLUSIONS: Females were at higher risk of in-hospital and 
      long-term cardiac mortality and ischemic stroke after PPCI for STEMI. Future 
      studies are warranted to investigate the role of aggressive management of 
      cardiovascular risk factors and follow-up to improve outcomes in the females with 
      STEMI.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Ngiam, Jinghao Nicholas
AU  - Ngiam JN
AD  - Department of Medicine, National University Health System, Singapore, 1E Kent 
      Ridge Rd, NUHS Tower Block, Level 9 119228, Singapore. Electronic address: 
      nicholas_ngiam@nuhs.edu.sg.
FAU - Thong, Elizabeth Hui-En
AU  - Thong EH
AD  - Department of Medicine, National University Health System, Singapore, 1E Kent 
      Ridge Rd, NUHS Tower Block, Level 9 119228, Singapore.
FAU - Loh, Poay Huan
AU  - Loh PH
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore.
FAU - Chan, Koo Hui
AU  - Chan KH
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore.
FAU - Chan, Mark Y
AU  - Chan MY
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore.
FAU - Lee, Chi-Hang
AU  - Lee CH
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore.
FAU - Low, Adrian F
AU  - Low AF
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore.
FAU - Tan, Huay Cheem
AU  - Tan HC
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore.
FAU - Loh, Joshua P
AU  - Loh JP
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore.
FAU - Sim, Hui Wen
AU  - Sim HW
AD  - Department of Cardiology, National University Heart Centre, National University 
      Health System, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20211120
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
SB  - IM
MH  - Aged, 80 and over
MH  - Asian People/*statistics & numerical data
MH  - Brain Ischemia/diagnosis/ethnology/*mortality
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Ischemic Stroke/diagnosis/ethnology/*mortality
MH  - Male
MH  - Percutaneous Coronary Intervention/*adverse effects
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *ST Elevation Myocardial Infarction/diagnostic imaging/surgery
MH  - Sex Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Gender
OT  - Ischemic stroke
OT  - Mortality
OT  - STEMI
COIS- Declaration of Competing Interest None reported. The authors declare no conflict 
      of interest.
EDAT- 2021/11/24 06:00
MHDA- 2022/02/05 06:00
CRDT- 2021/11/23 20:18
PHST- 2021/09/17 00:00 [received]
PHST- 2021/10/31 00:00 [accepted]
PHST- 2021/11/24 06:00 [pubmed]
PHST- 2022/02/05 06:00 [medline]
PHST- 2021/11/23 20:18 [entrez]
AID - S1052-3057(21)00620-0 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2021.106215 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2022 Jan;31(1):106215. doi: 
      10.1016/j.jstrokecerebrovasdis.2021.106215. Epub 2021 Nov 20.