Kosuge Masami, Kimura Kazuo, Kojima Sunao, Sakamoto Tomohiro, Ishihara Masaharu, Asada Yujiro, Tei Chuwa, Miyazaki Shunichi, Sonoda Masahiro, Tsuchihashi Kazufumi, Yamagishi Masakazu, Ikeda Yoshihiko, Shirai Mutsunori, Hiraoka Hisatoyo, Inoue Takeshi, Saito Fumio, Ogawa Hisao
Division of Cardiology, Yokohama City University Medical Center, Japan.
Circ J. 2006 Mar;70(3):217-21. doi: 10.1253/circj.70.217.
Limited information exists regarding the impact of gender on in-hospital outcome after primary stenting for acute myocardial infarction (AMI).
A total of 2,981 patients (790 women and 2,191 men) participated in the study who were admitted within 24 h after symptom onset and underwent emergency primary stenting for AMI. Compared with men, women were significantly older; had higher incidences of hypertension, diabetes mellitus, hyperlipidemia, Killip class > or =2, and cardiogenic shock; had a higher blood glucose level and a lower serum creatinine level on admission. Other baseline characteristics, including the incidences of ST-segment elevation AMI, anterior infarction, 3-vessel disease, initial or final Thrombolysis in Myocardial Infarction (TIMI) flow grade did not significantly differ between the sexes. The in-hospital mortality rate was significantly higher in women than in men (9.4% vs 5.2%, p<0.001). On multivariate analysis, age, Killip class, blood glucose level, serum creatinine level, and final TIMI grade were independent predictors of in-hospital death, but female gender was not (odds ratio 1.01, p=0.69).
Our findings suggest that in patients undergoing primary stenting for AMI, women have higher in-hospital mortality than men, but female gender itself is not independently associated with increased in-hospital mortality after adjustment for baseline differences.
关于性别对急性心肌梗死（AMI）初次支架置入术后院内结局的影响，现有信息有限。
共有2981例患者（790例女性和2191例男性）参与了本研究，这些患者在症状发作后24小时内入院，并接受了AMI急诊初次支架置入术。与男性相比，女性年龄显著更大；高血压、糖尿病、高脂血症、Killip分级≥2级和心源性休克的发生率更高；入院时血糖水平更高，血清肌酐水平更低。其他基线特征，包括ST段抬高型AMI、前壁梗死、三支血管病变的发生率，初始或最终心肌梗死溶栓治疗（TIMI）血流分级在性别之间无显著差异。女性的院内死亡率显著高于男性（9.4%对5.2%，p<0.001）。多变量分析显示，年龄、Killip分级、血糖水平、血清肌酐水平和最终TIMI分级是院内死亡的独立预测因素，但女性性别不是（比值比1.01，p=0.69）。
我们的研究结果表明，在接受AMI初次支架置入术的患者中，女性的院内死亡率高于男性，但在调整基线差异后，女性性别本身与院内死亡率增加无独立相关性。
