Sex‐specific treatment effects after primary percutaneous intervention: a study on coronary blood flow and delay to hospital presentation

Znanstveni rad - Izvorni znanstveni rad

• Autor: Edina Cenko
• Autor: Mihaela van der Schaar
• Autor: Jinsung Yoon
• Autor: Sasko Kedev
• Autor: Marija Valvukis
• Autor: Zorana Vasiljevic
• Autor: Milika Ašanin
• Autor: Davor Miličić
• Autor: Olivia Manfrini
• Autor: Lina Badimon
• Autor: Raffaele Bugiardini
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti

Sažetak (engleski)

Background: We hypothesized that female sex is a treatment effect modifier of blood flow and related 30-day mortality after
primary percutaneous coronary intervention (PCI) for ST-segment–elevation myocardial infarction and that the magnitude of the
effect on outcomes differs depending on delay to hospital presentation. -----
Methods and Results: We identified 2596 patients enrolled in the ISACS-TC (International Survey of Acute Coronary Syndromes
in Transitional Countries) registry from 2010 to 2016. Primary outcome was the occurrence of 30-day mortality. Key secondary
outcome was the rate of suboptimal post-PCI Thrombolysis in Myocardial Infarction (TIMI; flow grade 0–2). Multivariate logistic
regression and inverse probability of treatment weighted models were adjusted for baseline clinical covariates. We characterized
patient outcomes associated with a delay from symptom onset to hospital presentation of ≤120 minutes. In multivariable
regression models, female sex was associated with postprocedural TIMI flow grade 0 to 2 (odds ratio [OR], 1.68; 95% CI, 1.15–
2.44) and higher mortality (OR, 1.72; 95% CI, 1.02–2.90). Using inverse probability of treatment weighting, 30-day mortality was
higher in women compared with men (4.8% versus 2.5%; OR, 2.00; 95% CI, 1.27–3.15). Likewise, we found a significant sex
difference in post-PCI TIMI flow grade 0 to 2 (8.8% versus 5.0%; OR, 1.83; 95% CI, 1.31–2.56). The sex gap in mortality was no
longer significant for patients having hospital presentation of ≤120 minutes (OR, 1.28; 95% CI, 0.35–4.69). Sex difference in post-
PCI TIMI flow grade was consistent regardless of time to hospital presentation. -----
Conclusions: Delay to hospital presentation and suboptimal post-PCI TIMI flow grade are variables independently associated with
excess mortality in women, suggesting complementary mechanisms of reduced survival.

• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Izvorni znanstveni rad
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Objavljena verzija rada (izdavačev PDF)
• Naslov časopisa: Journal of the American Heart Association
• Brojčani podaci: vol. 8, br. 4
• p-ISSN: 2047-9980
• DOI: https://doi.org/10.1161/JAHA.118.011190
• URN:NBN: urn:nbn:hr:105:826747
• Datum objave publikacije: 2019-02-19
• URL dokumenta: http://doi.org/10.1161/JAHA.118.011190
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2024-03-28 10:27:44