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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
Z Motovska, P Widimsky, M Aschermann, Study Group Investigators PRAGUE
Language English Country Great Britain
NLK
ProQuest Central
from 1996-01-01 to 3 months ago
Health & Medicine (ProQuest)
from 1996-01-01 to 3 months ago
- MeSH
- Angioplasty, Balloon, Coronary methods mortality MeSH
- Epidemiologic Methods MeSH
- Financing, Organized MeSH
- Myocardial Infarction drug therapy mortality therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Patient Transfer methods MeSH
- Randomized Controlled Trials as Topic MeSH
- Myocardial Reperfusion methods mortality MeSH
- Aged MeSH
- Sex Factors MeSH
- Cardiac Catheterization methods mortality MeSH
- Thrombolytic Therapy methods mortality MeSH
- Age Distribution MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
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
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- $a 3rd Faculty of Medicine, Charles University and Cardiocentre Kralovske Vinohrady, Prague, Czech Republic. zuzana.motovska@iex.cz
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- $a 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
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