Gender Differences in Clinical Features and In-hospital Outcomes in ST-segment Elevation Acute Myocardial Infarction: From the Korean Acute Myocardial Infarction Registry (KAMIR) Study

Abstract

Background: Studies have suggested that women are biologically different and that female gender itself is independently associated with poor clinical outcome after an acute myocardial infarction (AMI). Hypothesis: We analyzed data from the Korean Acute Myocardial InfarctionRegistry (KAMIR) to assess gender differences in in-hospital outcomes post ST-segment elevation myocardial infarction (STEMI). Methods: Between November 2005 and July 2007, 4037 patientswho were admitted with STEMI to 41 facilities were registered into the KAMIR database; patients admitted within 72 hours of symptom onset were selected andincludedinthisstudy. Results: The proportion of patients who had reperfusion therapy within 12 hours from chest pain onset was lower in women. Women had higher rates of in-hospital mortality (8.6% vs 3.2%, P <.01), noncardiac death (1.5% vs 0.4%, P <.01), cardiac death (7.1% vs 2.8%, P <.01), and stroke (1.2% vs 0.5%, P <.05) than men. Multivariate logistic regression analysis identified age, previous angina, hypertension, a Killip class ≥ II, a left ventricular ejection fraction (LVEF) <40%, and a thrombolysis in myocardial infarction flow (TIMI) grade ≤3 after angioplasty as independent risk factors for in-hospitaldeath for all patients; however, female gender itself was not an independent risk factor. Conclusions: The results of this study show that although women have a higher in-hospital mortality than men, female gender itself is not an independent risk factor for in-hospital mortality.