Men and women with an acute STEMI had similar rates of all-cause mortality during the first 30 days after complete or incomplete revascularization, according to a study published in The American Journal of Cardiology.
However, at 5 years, men had better survival rates if they had complete revascularization, but the same was not true for women.
Aukelien C. Dimitriu-Leen, MD, of the department of cardiology at Leiden University Medical Center in the Netherlands, and colleagues analyzed data from 375 men (mean age, 61 years) and 115 women (mean age, 69 years) with their first acute STEMI and multivessel CAD between 2004 and 2008. Patients with a history of CAD, left main stenosis or cardiogenic shock at admission were excluded from the study.
The treating interventional cardiologists determined whether the patient underwent staged or immediate revascularization of the non-culprit vessel before discharge.
The endpoint of interest was all-cause mortality. Follow-up was conducted at 30 days and periodically up to 5 years.
At 30 days, men and women who underwent incomplete revascularization had increased rates of mortality vs. men who underwent complete revascularization. After adjusting for angiographic features and baseline characteristics, the gender-strategy interaction variable was not independently linked to mortality after STEMI at 30 days in men who underwent complete revascularization.
Incomplete revascularization was independently linked to all-cause mortality at 5 years in men (HR = 3.07; 95% CI, 1.24-7.61), although this relationship was not seen in women (HR = 0.6; 95% CI, 0.14-2.51).
“In the present study, the first 30 days were excluded from the long-term follow-up analysis. This is relevant since the mortality rate in the first 30 days is high and long-term results will be largely influenced by the outcome of the first 30 days,” Dimitriu-Leen and colleagues wrote. “It is hypothesized that men have more benefit from complete revascularization compared with women since women tend to have fewer non-culprit lesions with more often focal lesions with smaller minimal lumen area.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.