The Effect Of Gender On Emergency Percutaneous Coronary Interventional Therapy

Objective: We sought to compare women and men undergoing primary percutaneous coronary intervention(PCI)for STEMI on immediate effect and prognosis.Methods: The present study included consecutive patients with STEMI treated with emergency percutaneous coronary intervention(PCI)in our hospital from January 2012 to December 2014.A study of retrospective analysis on the immediate effects and prognosis of patients with emergency PCI between men and women,85 of whom were women.Inclusion Criteria: the diagnosis of STEMI and PCI patients received emergency treatment.The diagnostic standard of STEMI:persistent chest pain was greater than 30 min;the ECG showed more than 2 adjacent leads ST segment elevation of at least 0.1 m V or new left bundle branch block;the dynamic increase of cardiac markers.emergency PCI:1)STEMI within 12 hours of symptom onset;2)Serious heart failure or cardiogenic shock;3)The time of myocardial infarction still have symptoms of myocardial ischemia or hemodynamic instability in 12-24 hours.Two groups were treated with aspirin and clopidogrel double anticoagulation for at least 6 months after operation.Exclusion criteria:1)severe bleeding or within 12 months had been suffering from hemorrhagic stroke;2)patients with severe infection,cancer,autoimmune diseases or life expectancy less than 1 months;3)with serious liver and kidney failure;4)because of peripheral emboli or interventional treatment operation caused by STEMI.Analysis and comparison of two groups of male and female patients in the general clinical condition,coronary angiography and PCI immediate treatment and prognosis difference.All data were analyzed using SPSS17.0,if P is less than 0.05 indicates that the difference was statistically significant.Results: Of the 282 patients,197 were male(69.86%),and 85 were female(30.14%).The average age of the women were elder than men((63.68±7.76)years vs.(58.13±11.54)years,P<0.01).Hypertension(51.8% vs.42.6%,P<0.01),diabetes(41.1% vs.24.8%,P<0.05)and hyperlipidemia(38.8% vs.25.3%,P<0.01)prevalence of female patients were higher than male;and male smoking rate was higher than women(51.7% vs.23.5%,P<0.01).The rate of Cardiac function classification(Killip>?)about women with STEMI was higher than men(20.3% vs.5.9%,P<0.05),and women with Killip II(11.7% vs.2.5%,P<0.05)and Killip III(7.5% vs.1.5%,P< 0.05)were higher proportion.The proportion of women(2.35% vs.6.60%,P<0.05)who used statins was lower than that of men.Women with symptoms-onset-to-door time was significantly longer than that in male patients((223±28.36)minutes vs.(198.13±14.62)minutes,P< 0.01).The diameter of the stent in female patients was smaller than male patients((2.99±031)mm vs.(3.08±0.42)mm,P<0.05).Operative complications in female patients were more than male patients(3.52% vs.0.50%,P<0.01).At follow-up results showed that the ratio of female MACE patients was higher than male patients,but the difference was not statistically significant.In addition,there were also found that female patients received invasive CAG examination rate 6 months after discharge was significantly lower than that of male patients(8.23% vs.18.70%,P<0.05).Conclusion: Female STEMI patients received emergency PCI before myocardial ischemia time,the condition is more severe.The female patients with emergency PCI tend to femoralartery operation,and to face a higher risk of operation.In terms of immediate effect and prognosis of emergency PCI,both men and women have the benefit,but not the gender as an independent risk factor for predicting major adverse cardiac events after emergency PCI.