Pôle d'Activité Médicochirurgicale Cardiovasculaire, Unité de Soins Intensifs Cardiologiques - Nouvel Hôpital Civil, Place de l'Hôpital, 67000 Strasbourg - France.
BMC Cardiovasc Disord. 2010 Jun 24;10:31. doi: 10.1186/1471-2261-10-31.
To analyze the in-hospital complication rate in women suffering from non-ST elevation myocardial infarction treated with percutaneous coronary intervention (PCI) compared to men.
The files of 479 consecutive patients (133 women and 346 men) suffering from a Non STEMI (Non ST-segment elevation myocardial infarction) between the January 1st 2006 and March 21st 2009 were retrospectively analyzed with special attention to every single complication occurring during hospital stay. Data were analyzed using nonparametric tests and are reported as median unless otherwise specified. A p value < .05 was considered significant.
As compared to men, women were significantly older (75.8 vs. 65.2 years; p < .005). All cardiovascular risk factors but tobacco and hypertension were similar between the groups: men were noticeably more often smoker (p < .0001) and women more hypertensive (p < .005). No difference was noticed for pre-hospital cardiovascular drug treatment. However women were slightly more severe at entry (more Killip class IV; p = .0023; higher GRACE score for in-hospital death - p = .008 and CRUSADE score for bleeding - p < .0001). All the patients underwent PCI of the infarct-related artery after 24 or 48 hrs post admission without sex-related difference either for timing of PCI or primary success rate. During hospitalization, 130 complications were recorded. Though the event rate was slightly higher in women (30% vs. 26% - p = NS), no single event was significantly gender related. The logistic regression identified age and CRP concentration as the only predictive variables in the whole group. After splitting for genders, these parameters were still predictive of events in men. In women however, CRP was the only one with a borderline p value.
Our study does not support any gender difference for in-hospital adverse events in patients treated invasively for an acute coronary syndrome without ST-segment elevation and elevated troponin.
分析接受经皮冠状动脉介入治疗（PCI）的非 ST 段抬高型心肌梗死（NSTEMI）女性患者与男性患者的院内并发症发生率。
回顾性分析 2006 年 1 月 1 日至 2009 年 3 月 21 日期间连续收治的 479 例 NSTEMI 患者（女性 133 例，男性 346 例）的病历资料，特别关注住院期间发生的每一种并发症。使用非参数检验对数据进行分析，除非另有说明，否则均以中位数表示。p 值<.05 为差异有统计学意义。
与男性相比，女性患者明显更年长（75.8 岁 vs. 65.2 岁；p<.005）。两组患者的所有心血管危险因素除了吸烟和高血压外均相似：男性患者明显更多为吸烟者（p<.0001），女性患者更多为高血压患者（p<.005）。但两组患者在入院前心血管药物治疗方面无差异。然而，女性患者入院时病情略严重（更多为 Killip Ⅳ级；p=0.0023；院内死亡 GRACE 评分更高-p=0.008，出血 CRUSADE 评分更高-p<.0001）。所有患者在入院后 24 或 48 小时内行梗死相关动脉 PCI，在 PCI 时间或初次成功率方面均无性别差异。住院期间共记录到 130 种并发症。尽管女性患者的事件发生率略高（30% vs. 26%-p=NS），但无单一事件与性别明显相关。Logistic 回归分析确定年龄和 CRP 浓度是整个研究人群中唯一的预测变量。在按性别分层后，这些参数在男性患者中仍然是预测事件的因素。然而，在女性患者中，只有 CRP 具有临界 p 值。
本研究不支持在接受经皮冠状动脉介入治疗的急性冠状动脉综合征（不伴 ST 段抬高和肌钙蛋白升高）女性患者中存在任何与性别相关的院内不良事件差异。
