Gender and myocardial salvage after reperfusion treatment in acute myocardial infarction.


OBJECTIVES The aim of this study was to investigate whether there are gender-associated differences in the amount of myocardial salvage after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). BACKGROUND Despite having a more adverse cardiovascular risk profile, women with AMI have similar or even better outcomes after primary PCI compared with men. The reasons for these findings are unclear. METHODS In this study we included 202 women and 561 men with AMI who underwent primary PCI in the setting of three randomized trials. The primary end point of the study was myocardial salvage index (proportion of initial perfusion defect salvaged by reperfusion therapy), obtained by paired scintigraphic studies performed 7 to 10 days apart. RESULTS The amount of myocardium at risk or initial perfusion defect (median [25th, 75th percentiles]) did not differ significantly between women and men (22.0% [12.0, 40.0] vs. 24.0% [14.0, 39.0] of the left ventricle [LV], p = 0.26). Final infarct size, measured in the follow-up scintigraphy, was significantly smaller in women than in men (6.0% [0.71, 18.7] vs. 10.0% [3.9, 21.8] of the LV, p = 0.001). Myocardial salvage index was 0.64 (0.35, 0.95) in women versus 0.50 (0.26, 0.77) in men (p < 0.001). After adjustment for baseline characteristics, female gender was an independent predictor of greater myocardial salvage after PCI (p = 0.002). CONCLUSIONS The efficacy of primary PCI in patients with AMI appears to be gender-dependent. Myocardial salvage achieved by primary PCI is greater in women than in men.

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@article{Mehilli2005GenderAM, title={Gender and myocardial salvage after reperfusion treatment in acute myocardial infarction.}, author={Julinda Mehilli and Gjin Ndrepepa and Adnan Kastrati and Stephan G. Nekolla and Christina Markwardt and Hildegard Bollwein and J{\"{u}rgen Pache and Stefan Martinoff and Josef Dirschinger and Markus Schwaiger and Albert Schoemig}, journal={Journal of the American College of Cardiology}, year={2005}, volume={45 6}, pages={828-31} }