We sought to investigate sex differences in clinical characteristics, treatment and in in-hospital mortality in patients admitted with ST elevation myocardial infarction (STEMI) in Serbia. From October 2010 to September 2013, a total of 2348 patients have been hospitalized and received medical treatment for STEMI in 19 hospitals, referring data to the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC) registry. There were 773 women and 1575 men. Women were older than man, with a higher prevalence of family history of coronary artery disease, hypertension, and diabetes. They were less likely to be smokers and more likely to have a prior angina and history of heart failure. Fewer women than men presented within 2 h from symptom onset (P = 0.005). They presented more with Killip class ≥2 than men (P = 0.004). A significantly lower proportion of women was treated with aspirin (91.3% vs 94.3%, P = 0.007), clopidogrel (88% vs. 91%, P = 0.02), heparins (61.6% vs. 66.5%, P = 0.01) and primary percutaneous coronary interventions (62.1% vs. 69.7%, P < 0.001). The in-hospital mortality was significantly higher for women than for men (13.2% vs. 6.4%, P < 0.001). After adjustment for any confounders, women showed an increased risk of in-hospital mortality (odds ratio: 1.97, 95% confidence interval: 1.28–3.01, P = 0.002). Several factors contribute to the excess in-hospital case fatality rates in Serbian women. Most notably disparities in medical treatment appear to play a crucial role.

Gender differences in case fatality rates of acute myocardial infarction in Serbia

CENKO, EDINA;MANFRINI, OLIVIA;MARTELLI, IRENE;BUGIARDINI, RAFFAELE
2014

Abstract

We sought to investigate sex differences in clinical characteristics, treatment and in in-hospital mortality in patients admitted with ST elevation myocardial infarction (STEMI) in Serbia. From October 2010 to September 2013, a total of 2348 patients have been hospitalized and received medical treatment for STEMI in 19 hospitals, referring data to the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC) registry. There were 773 women and 1575 men. Women were older than man, with a higher prevalence of family history of coronary artery disease, hypertension, and diabetes. They were less likely to be smokers and more likely to have a prior angina and history of heart failure. Fewer women than men presented within 2 h from symptom onset (P = 0.005). They presented more with Killip class ≥2 than men (P = 0.004). A significantly lower proportion of women was treated with aspirin (91.3% vs 94.3%, P = 0.007), clopidogrel (88% vs. 91%, P = 0.02), heparins (61.6% vs. 66.5%, P = 0.01) and primary percutaneous coronary interventions (62.1% vs. 69.7%, P < 0.001). The in-hospital mortality was significantly higher for women than for men (13.2% vs. 6.4%, P < 0.001). After adjustment for any confounders, women showed an increased risk of in-hospital mortality (odds ratio: 1.97, 95% confidence interval: 1.28–3.01, P = 0.002). Several factors contribute to the excess in-hospital case fatality rates in Serbian women. Most notably disparities in medical treatment appear to play a crucial role.
2014
Z. Vasiljevic;G. Krljanac;G. Davidovic;G. Panic;S. Radovanovic;N. Mickovski;N. Srbljak;N. Markovic-Nikolic;S. Curic-Petkovic;M. Panic;E. Cenko;O. Manfrini;I. Martelli;A. Koller;L. Badimon;R. Bugiardini
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/218471
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