Sleiman Elsa, Hosry Jeff, Caruana Lisa, Schwartz Moishe, Boutros Karam, Tabet Rabih, Salmane Chadi, Kandov Ruben, Royzman Roman, Tamburrino Frank, Lafferty James
From the Department of Internal Medicine, Staten Island University Hospital, NY.
Department of Quality Improvement, Cardiology, Staten Island University Hospital, NY.
Crit Pathw Cardiol. 2021 Jun 1;20(2):63-66. doi: 10.1097/HPC.0000000000000238.
Door-to-balloon (DTB) time of primary percutaneous coronary intervention in ST-elevation myocardial infarction (STEMI) is a predictive indicator of outcomes and mortality. Traditional gender-related differences that existed in the provision of DTB in STEMI had been allegedly improving until recent controversial data showed re-emergence of longer DTB in females. The objective of our study was to compare circadian disparities in percutaneous coronary intervention for STEMI according to gender in our institution. We compared DTB and symptom-to-balloon (STB) as well as mortality outcomes in a registry of 514 patients. We studied 117 females and 397 males. Baseline characteristics and cardiovascular risk factors were similar among both populations. Men used more self-transportation (51% vs. 38%) compared with women. Both had similar DTB median times: males, 63 (47-79) min; and females, 61 (44-76) min. In addition, STB median times were also similar: males, 155 (116-264) min; and females, 165 (115-261) min. Mortality outcomes at 1 month were comparable at 3% in males versus 0.9% in females (P = 0.164). In a review of a tertiary care center in New York, we observed no gender differences in DTB and STB, endorsing the role of emergency medical service transportation in eliminating disparities.
ST段抬高型心肌梗死（STEMI）患者接受初次经皮冠状动脉介入治疗时的门球时间（DTB）是预后和死亡率的预测指标。在STEMI患者的DTB治疗方面，传统的性别差异据称一直在改善，直到最近有争议的数据显示女性的DTB时间再次变长。我们研究的目的是比较我院根据性别进行的STEMI经皮冠状动脉介入治疗的昼夜差异。我们在一个包含514例患者的登记系统中比较了DTB、症状到球囊时间（STB）以及死亡率。我们研究了117名女性和397名男性。两组人群的基线特征和心血管危险因素相似。与女性相比，男性更多地使用自行转运（51%对38%）。两者的DTB中位数时间相似：男性为63（47 - 79）分钟；女性为61（44 - 76）分钟。此外，STB中位数时间也相似：男性为155（116 - 264）分钟；女性为165（115 - 261）分钟。1个月时的死亡率结果相当，男性为3%，女性为0.9%（P = 0.164）。在对纽约一家三级医疗中心的回顾中，我们观察到DTB和STB方面不存在性别差异，这支持了紧急医疗服务转运在消除差异方面的作用。
