The impact of gender on outcomes of patients with ST elevation myocardial infarction transported for percutaneous coronary intervention. Analysis of the PRAGUE 1 and 2 studies

Zuzana Motovska ^1*, Petr Widimsky ¹ and Michael Aschermann ²

¹ 3rd Medical Faculty of Charles University, Czech Republic
² 1st Medical faculty of Charles University, Czech Republic

^* To whom correspondence should be addressed. E-mail: zuzana.motovska{at}iex.cz.

Accepted 26 June 2007

Abstract

Background Data comparing survival outcomes for women vs men transported for pPCI absent.

Objectives To asses the impact of gender on 30-day mortality of patients with STEMI transported for pPCI.

Methods. The data from the PRAGUE-1 and PRAGUE-2 trials were analyzed. Studies compared thrombolysis in the community hospital and pPCI after transport to cardiocentre. We analysed a group of 520 patients treated with thrombolysis and 530 transported to pPCI.

Results Women were older, with a higher risk profile. They had longer ischemia time. Mortality of patients treated with TL was significantly higher in women compared to men (15% vs. 9%, p=0,043). There was no significant gender difference in mortality in the PCI group (8,2% of women vs. 6,2% of men, p=0,409). Mortality of women treated with on-site TL was nearly twice as high as mortality of women transported for pPCI (p=0,043). After adjustment in a multivariate model the odds ratio for mortality in females was 0.74 (95% CI. 0.26-2.05; P=0,556)

Conclusion Long distance transport of women with STEMI from a community hospital to a tertiary PCI centre is a significantly more effective treatment strategy than on-site TL. Gender did not determine survival in patients transported for pPCI.

Keywords: gender, myocardial infarction, transport for percutaneous coronary intervention

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