Comparison of in-hospital outcome in men versus women treated by either thrombolytic therapy or primary coronary angioplasty for acute myocardial infarction
| Autor: | Gregg W. Stone, James O'Keefe, Paul Overlie, Bryan Donohue, Donald Rothbaum, Cindy L. Grines, Sylvia Puchrowicz-Ochocki, Geoffrey O. Hartzler, Jean Marco, Kevin F. Browne, Noah Chelliah, William W. O'Neill, Ronald Vlietstra |
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| Rok vydání: | 1995 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous transluminal coronary angioplasty medicine.medical_treatment education Myocardial Infarction Tissue plasminogen activator Sex Factors Internal medicine Angioplasty medicine Humans Thrombolytic Therapy Prospective Studies Pica (disorder) Myocardial infarction Angioplasty Balloon Coronary Aged Cerebral Hemorrhage Chemotherapy business.industry Age Factors Middle Aged Prognosis medicine.disease United States Coronary heart disease Hospitalization Logistic Models Treatment Outcome Hospital outcomes Tissue Plasminogen Activator Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | The American Journal of Cardiology. 75:987-992 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/s0002-9149(99)80709-7 |
| Popis: | At 12 centers, 395 patients, including 288 men (73%) and 107 women (27%) with acute myocardial infarction (AMI), were prospectively randomized to treatment with tissue plasminogen activator (t-PA) or primary percutaneous transluminal coronary angioplasty (PTCA). Compared with men, women were older (65.7 vs 57.7 years, p0.0001), more often had diabetes mellitus (19% vs 10%, p = 0.03), systemic hypertension (54% vs 39%, p = 0.005), prior congestive heart failure (5% vs 0%, p = 0.002), and presented later after symptom onset (229 vs 174 minutes, p = 0.0004). The in-hospital mortality in women was 3.3-fold higher than men (9.3% vs 2.8%, p = 0.005). After adjustment for comorbid baseline characteristics, however, only advanced age independently correlated with mortality. Among t-PA-treated patients, mortality was significantly higher in women than in men (14.0% vs 3.5%, p = 0.006). Intracranial hemorrhage after t-PA was also more common in women than in men (5.3% vs 0.7%, p = 0.037). In contrast, women and men had similar in-hospital mortality after primary PTCA (4.0% vs 2.1%, respectively, p = 0.46). No intracranial bleeding occurred in PTCA-treated patients. A univariate trend was present for reduced in-hospital mortality in women treated with PTCA rather than t-PA (4.0% vs 14.0%, p = 0.07). By multiple logistic regression analysis of 15 clinical variables, treatment with PTCA rather than t-PA, as well as younger age, were independently predictive of in-hospital survival in women.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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