Gender Differences in Outcomes After Primary PCI in Acute Myocardial Infarction
DOI:
https://doi.org/10.70749/ijbr.v2i02.161Keywords:
Gender Differences, Acute Myocardial Infarction, Primary PCI, Pakistan, STEMIAbstract
Objective: To investigate gender differences in clinical outcomes after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), highlighting insights within a Pakistani healthcare context.
Methodology: Conducted over ten months at the Hayatabad Medical Complex, Peshawar, this prospective observational study enrolled 300 AMI patients (150 males, 150 females) treated with primary PCI. Key parameters analyzed included AMI type, demographic characteristics, post-procedure complications, and mortality rates. Statistical analysis was conducted using chi-square tests to examine the association between gender and outcome disparities.
Results: The findings revealed that men predominantly presented with STEMI, accounting for higher complication rates and adverse outcomes compared to women. Male patients demonstrated a 22% incidence of major adverse cardiac events (MACE), while female patients showed a 14% MACE rate, predominantly among NSTEMI cases. The age distribution for both genders was centered in the 50-70 age range, with no statistically significant association between gender and overall outcomes (p = 0.582). These results align with international trends yet emphasize the need for gender-sensitive approaches in PCI care within Pakistan.
Conclusion: The study underscores notable gender disparities in AMI presentation and outcomes following PCI. Men face higher risks, particularly with STEMI, suggesting a critical need for gender-specific protocols in AMI management. These findings support further multi-center research to enhance gender-responsive healthcare strategies in Pakistan.
References
Ndrepepa, G., Kufner, S., Mayer, K., Cassese, S., Xhepa, E., Fusaro, M., Hasimi, E., Schüpke, S., Laugwitz, K.-L., Schunkert, H., & Kastrati, A. (2019). Sex differences in the outcome after percutaneous coronary intervention - A propensity matching analysis. Cardiovascular Revascularization Medicine: Including Molecular Interventions, 20(2), 101–107. https://doi.org/10.1016/j.carrev.2018.05.010
Cenko, E., van der Schaar, M., Yoon, J., Kedev, S., Valvukis, M., Vasiljevic, Z., Ašanin, M., Miličić, D., Manfrini, O., Badimon, L., & Bugiardini, R. (2019). Sex-specific treatment effects after primary percutaneous intervention: A study on coronary blood flow and delay to hospital presentation. Journal of the American Heart Association, 8(4), e011190. https://doi.org/10.1161/JAHA.118.011190
Shah, T., Haimi, I., Yang, Y., Gaston, S., Taoutel, R., Mehta, S., Lee, H. J., Zambahari, R., Baumbach, A., Henry, T. D., Grines, C. L., Lansky, A., & Tirziu, D. (2021). Meta-analysis of gender disparities in in-hospital care and outcomes in patients with ST-segment elevation myocardial infarction. The American Journal of Cardiology, 147, 23–32. https://doi.org/10.1016/j.amjcard.2021.02.015
Artani, A., Baloch, F., Laghari, A., Siddiqui, F., Artani, M., & Kazmi, K. (2022). Sex-stratified outcomes of primary percutaneous coronary intervention: A tertiary care experience. Asian Cardiovascular & Thoracic Annals, 30(2), 164–170. https://doi.org/10.1177/02184923211014001
Vallabhajosyula, S., Vallabhajosyula, S., Dunlay, S. M., Hayes, S. N., Best, P. J. M., Brenes-Salazar, J. A., Lerman, A., Gersh, B. J., Jaffe, A. S., Bell, M. R., Holmes, D. R., Jr, & Barsness, G. W. (2020). Sex and gender disparities in the management and outcomes of acute myocardial infarction-cardiogenic shock in older adults. Mayo Clinic Proceedings. Mayo Clinic, 95(9), 1916–1927. https://doi.org/10.1016/j.mayocp.2020.01.043
Mahajan, A. M., Claessen, B. E., Chandrasekhar, J., Sartori, S., Aquino, M., Baber, U., Dangas, G., Kovacic, J. C., Krishnan, P., Moreno, P., Sweeny, J., Barman, N., Vijay, P., Kini, A., Mehran, R., & Sharma, S. (2019). Outcomes by gender and ethnicity after percutaneous coronary intervention. The American Journal of Cardiology, 123(12), 1941–1948. https://doi.org/10.1016/j.amjcard.2019.03.019
Viana-Llamas, M. C., Silva-Obregon, A., Arroyo Espliguero, R., Estrella-Alonso, A., Saboya-Sanchez, S., Uribe-Heredia, G., Garcia-Magallon, B., Toran-Martinez, C., Castillo-Sandoval, A., Eguileor-Marin, Z., Arriero-Fernandez, N., & Marian-Crespo, C. (2019). P3451Female gender is an independent predictor of one-year mortality following primary angioplasty for ST-segment elevation myocardial infarction, regardless of age, clinical severity and frailty. European Heart Journal, 40(Supplement_1). https://doi.org/10.1093/eurheartj/ehz745.0324
Jang, J.-S., Yang, T.-H., Kim, D.-K., Kim, D.-S., Park, E.-J., & Jeong, Y.-J. (2019). Gender difference in long-term outcomes among acute myocardial infarction patients undergoing percutaneous coronary intervention. Journal of the American College of Cardiology, 73(9), 129. https://doi.org/10.1016/s0735-1097(19)30737-5
Lee, Myunhee, Kim, D.-W., Park, M.-W., Lee, K., Chang, K., Chung, W. S., Ahn, T. H., Jeong, M. H., Rha, S.-W., Kim, H.-S., Gwon, H. C., Seong, I. W., Hwang, K. K., Chae, S. C., Kim, K.-B., Kim, Y. J., Cha, K. S., Oh, S. K., Chae, J. K., … On Behalf Of Kamir-Nih Registry Investigators. (2020). Gender differences in clinical outcomes of acute myocardial infarction undergoing percutaneous coronary intervention: insights from the KAMIR-NIH Registry. Journal of Geriatric Cardiology: JGC, 17(11), 680–693. https://doi.org/10.11909/j.issn.1671-5411.2020.11.006
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