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Effect of invasive strategy on different genders of chinese patients with non‐ST‐elevation myocardial infarction
Author(s) -
Huang ShaoSung,
Chen YingHwa,
Lu TseMin,
Wu TaoCheng,
Charng MinJi,
Chen JawWen,
Pan JuPin,
Lin ShingJong
Publication year - 2011
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.23166
Subject(s) - medicine , revascularization , myocardial infarction , hazard ratio , clinical endpoint , cardiology , proportional hazards model , confidence interval , clinical trial
Objectives : The aim of this study was to determine the impact of in‐hospital revascularization on different genders and to compare the gender difference in short‐ and long‐term prognosis of Chinese patients with non‐ST‐elevation myocardial infarction (NSTEMI). Background : The benefit of invasive strategy between the genders of Asian ethnic populations with NSTEMI remains unclear. Methods : A total of 343 consecutive NSTEMI patients were enrolled, 104 (30%) of them were women. All patients were followed up for at least 3 years or until the occurrence of a major event. The primary end point was all‐cause death. The secondary end point was the combined occurrence of death or myocardial (re‐)infarction (MI). Results : The adjusted in‐hospital and long‐term clinical outcomes were similar between men and women. However, in‐hospital revascularization significantly reduced long‐term mortality and composite endpoint in men ( P < 0.001), but not in women. After risk stratification by GRACE score, there was favorable effect of invasive strategy in high‐risk women. In a multivariate Cox regression analysis, GRACE score (hazard ratio; HR, 1.017; P < 0.001) and in‐hospital revascularization (HR, 0.516; P = 0.008) were the independent predictors of death or MI in men. However, only GRACE score was the independent predictor of composite endpoint in women (HR, 1.012; P = 0.004). Conclusions : In Asian ethnic patients with NSTEMI, the in‐hospital and long‐term prognosis were similar between men and women. In‐hospital revascularization has a benefit in men and high‐risk women for reducing the all‐cause death at 1 and 3 years. Our data provide evidence supporting the guideline recommendation for an invasive strategy in high‐risk women. © 2011 Wiley Periodicals, Inc.