After adjusting for age and comorbidity, female gender is no longer associated with mortality
TUESDAY, March 1 (HealthDay News) -- The association between female gender and increased mortality among patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) does not persist after adjusting for age and comorbidities, according to a study published in the January issue of the American Heart Journal.
Elizabeth A. Jackson, M.D., M.P.H., from the University of Michigan in Ann Arbor, and colleagues evaluated the impact of gender on the outcomes of 8,771 patients with acute STEMI who underwent primary PCI. Patients were participants in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium and were recruited from 32 hospitals between 2003 and 2008. Propensity-matched analysis was adjusted for baseline characteristics and comorbidities in men and women.
The researchers found that 29 percent of the cohort was female and that they were older and had more comorbidity than the men in the cohort. A statistically significant association was found between female sex and increased unadjusted in-hospital mortality, increased risk of contrast-induced nephropathy, vascular complications, and post-procedure transfusions. The difference in sex-specific mortality reduced over time. In a propensity-matched analysis, there was no difference in mortality, but female gender was linked to increased transfusion rates and vascular complications.
"Female sex was associated with an increased risk of mortality among patients receiving primary PCI for STEMI; however, this difference was no longer observed after controlling for age and higher rates of comorbidities," the authors write.