Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
Department of Health Sciences, University of York, Heslington, United Kingdom.
Asian Cardiovasc Thorac Ann. 2022 Feb;30(2):164-170. doi: 10.1177/02184923211014001. Epub 2021 May 4.
ST elevation myocardial infarction (STEMI) is an acute cardiac manifestation that requires immediate revascularization preferably through primary percutaneous coronary intervention (PCI). This study aims to describe gender stratified outcomes and epidemiological profile of STEMI patients undergoing treatment at a tertiary care hospital in Karachi, Pakistan.
A 5-year, retrospective analysis of hospital records was undertaken on confirmed STEMI patients admitted between 2010 and 2014, undergoing primary PCI. Information was retrieved on demographic variables, risk factors, total ischemia time, door to balloon time, angiographic findings, and treatment strategy and in-hospital outcomes.
A total of 603 patients were available for analysis. Mean age of the participants was 58 ± 11 years, with 78.6% being males. The most common risk factors were hypertension (48.1%), diabetes (37%), and smoking (22.2%). Gender stratified analysis revealed poorer clinical presentation and prolonged ischemia time among women when compared to men (410 vs. 310 min, respectively). Total in-hospital mortality was 9.6% and was higher in women (19.3%), patients with non-anterior infarction (12%), Killip class >2 (39%), advanced age (14.6%), and multi-vessel disease (12%).
Our study describes the common risk factors and treatment outcomes for STEMI patients undergoing primary PCI at a tertiary care hospital in Karachi. In-hospital mortality and total ischemia time were higher among women compared to men in our study. Moreover, the risk profile, treatment related complications, and outcomes were poorer in women compared to men. We suggest further research to investigate the effect of prolonged ischemia time on long-term clinical outcomes.
ST 段抬高型心肌梗死（STEMI）是一种需要立即血运重建的急性心脏表现，最好通过直接经皮冠状动脉介入治疗（PCI）进行。本研究旨在描述在巴基斯坦卡拉奇的一家三级护理医院接受治疗的 STEMI 患者的性别分层结局和流行病学特征。
对 2010 年至 2014 年期间接受直接 PCI 的确诊 STEMI 患者的医院记录进行了为期 5 年的回顾性分析。收集了人口统计学变量、危险因素、总缺血时间、门球时间、血管造影结果以及治疗策略和住院期间结局等信息。
共有 603 名患者可用于分析。参与者的平均年龄为 58±11 岁，其中 78.6%为男性。最常见的危险因素包括高血压（48.1%）、糖尿病（37%）和吸烟（22.2%）。性别分层分析显示，与男性相比，女性的临床表现更差，缺血时间更长（410 分钟比 310 分钟）。住院期间总死亡率为 9.6%，女性更高（19.3%），非前壁梗死患者（12%）、Killip 分级>2（39%）、年龄较大（14.6%）和多血管病变（12%）患者的死亡率更高。
本研究描述了在卡拉奇的一家三级护理医院接受直接 PCI 的 STEMI 患者的常见危险因素和治疗结局。与男性相比，女性的住院期间死亡率和总缺血时间更高。此外，女性的风险状况、与治疗相关的并发症和结局比男性更差。我们建议进一步研究，以调查长时间缺血对长期临床结局的影响。
