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In-hospital complications after invasive strategy for the management of Non STEMI: women fare as well as men.

Berthillot C, Stephan D, Chauvin M, Roul G - BMC Cardiovasc Disord (2010)

Bottom Line: A p value < .05 was considered significant.As compared to men, women were significantly older (75.8 vs. 65.2 years; p < .005).Our study does not support any gender difference for in-hospital adverse events in patients treated invasively for an acute coronary syndrome without ST-segment elevation and elevated troponin.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pôle d'Activité Médicochirurgicale Cardiovasculaire, Unité de Soins Intensifs Cardiologiques - Nouvel Hôpital Civil, Place de l'Hôpital, 67000 Strasbourg - France.

ABSTRACT

Background: To analyze the in-hospital complication rate in women suffering from non-ST elevation myocardial infarction treated with percutaneous coronary intervention (PCI) compared to men.

Methods: The files of 479 consecutive patients (133 women and 346 men) suffering from a Non STEMI (Non ST-segment elevation myocardial infarction) between the January 1st 2006 and March 21st 2009 were retrospectively analyzed with special attention to every single complication occurring during hospital stay. Data were analyzed using nonparametric tests and are reported as median unless otherwise specified. A p value < .05 was considered significant.

Results: As compared to men, women were significantly older (75.8 vs. 65.2 years; p < .005). All cardiovascular risk factors but tobacco and hypertension were similar between the groups: men were noticeably more often smoker (p < .0001) and women more hypertensive (p < .005). No difference was noticed for pre-hospital cardiovascular drug treatment. However women were slightly more severe at entry (more Killip class IV; p = .0023; higher GRACE score for in-hospital death - p = .008 and CRUSADE score for bleeding - p < .0001). All the patients underwent PCI of the infarct-related artery after 24 or 48 hrs post admission without sex-related difference either for timing of PCI or primary success rate. During hospitalization, 130 complications were recorded. Though the event rate was slightly higher in women (30% vs. 26% - p = NS), no single event was significantly gender related. The logistic regression identified age and CRP concentration as the only predictive variables in the whole group. After splitting for genders, these parameters were still predictive of events in men. In women however, CRP was the only one with a borderline p value.

Conclusions: Our study does not support any gender difference for in-hospital adverse events in patients treated invasively for an acute coronary syndrome without ST-segment elevation and elevated troponin.

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Related in: MedlinePlus

Time course of hemoglobin during hospital stay. Compared to baseline, both group as the same course as suggested by a 2-way ANOVA showing no significant group interaction.  §§§: p < 0.0001 compared to baseline. ‡‡‡: p < 0.0001 compared to minimal value.  ***: p < 0.0001 between women and men.
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Figure 1: Time course of hemoglobin during hospital stay. Compared to baseline, both group as the same course as suggested by a 2-way ANOVA showing no significant group interaction. §§§: p < 0.0001 compared to baseline. ‡‡‡: p < 0.0001 compared to minimal value. ***: p < 0.0001 between women and men.

Mentions: The biological characteristics at hospital entry are displayed in Table 4. Many classical parameters as well as Troponin I and BNP plasma level were similar between genders. Plasma glucose was significantly higher in women (p < 0.05). Hence, women also had more inflammation as suggested by both CRP (p < 0.05) and plasma fibrinogen (p < 0.002). In women we noted lower levels of hemoglobin (p < 0.0001) and of hematocrit (p < 0.0001) however with the same time course during hospitalization in both groups (Figure 1). Baseline renal function was reduced in women (p < 0.0001).


In-hospital complications after invasive strategy for the management of Non STEMI: women fare as well as men.

Berthillot C, Stephan D, Chauvin M, Roul G - BMC Cardiovasc Disord (2010)

Time course of hemoglobin during hospital stay. Compared to baseline, both group as the same course as suggested by a 2-way ANOVA showing no significant group interaction.  §§§: p < 0.0001 compared to baseline. ‡‡‡: p < 0.0001 compared to minimal value.  ***: p < 0.0001 between women and men.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2909149&req=5

Figure 1: Time course of hemoglobin during hospital stay. Compared to baseline, both group as the same course as suggested by a 2-way ANOVA showing no significant group interaction. §§§: p < 0.0001 compared to baseline. ‡‡‡: p < 0.0001 compared to minimal value. ***: p < 0.0001 between women and men.
Mentions: The biological characteristics at hospital entry are displayed in Table 4. Many classical parameters as well as Troponin I and BNP plasma level were similar between genders. Plasma glucose was significantly higher in women (p < 0.05). Hence, women also had more inflammation as suggested by both CRP (p < 0.05) and plasma fibrinogen (p < 0.002). In women we noted lower levels of hemoglobin (p < 0.0001) and of hematocrit (p < 0.0001) however with the same time course during hospitalization in both groups (Figure 1). Baseline renal function was reduced in women (p < 0.0001).

Bottom Line: A p value < .05 was considered significant.As compared to men, women were significantly older (75.8 vs. 65.2 years; p < .005).Our study does not support any gender difference for in-hospital adverse events in patients treated invasively for an acute coronary syndrome without ST-segment elevation and elevated troponin.

View Article: PubMed Central - HTML - PubMed

Affiliation: Pôle d'Activité Médicochirurgicale Cardiovasculaire, Unité de Soins Intensifs Cardiologiques - Nouvel Hôpital Civil, Place de l'Hôpital, 67000 Strasbourg - France.

ABSTRACT

Background: To analyze the in-hospital complication rate in women suffering from non-ST elevation myocardial infarction treated with percutaneous coronary intervention (PCI) compared to men.

Methods: The files of 479 consecutive patients (133 women and 346 men) suffering from a Non STEMI (Non ST-segment elevation myocardial infarction) between the January 1st 2006 and March 21st 2009 were retrospectively analyzed with special attention to every single complication occurring during hospital stay. Data were analyzed using nonparametric tests and are reported as median unless otherwise specified. A p value < .05 was considered significant.

Results: As compared to men, women were significantly older (75.8 vs. 65.2 years; p < .005). All cardiovascular risk factors but tobacco and hypertension were similar between the groups: men were noticeably more often smoker (p < .0001) and women more hypertensive (p < .005). No difference was noticed for pre-hospital cardiovascular drug treatment. However women were slightly more severe at entry (more Killip class IV; p = .0023; higher GRACE score for in-hospital death - p = .008 and CRUSADE score for bleeding - p < .0001). All the patients underwent PCI of the infarct-related artery after 24 or 48 hrs post admission without sex-related difference either for timing of PCI or primary success rate. During hospitalization, 130 complications were recorded. Though the event rate was slightly higher in women (30% vs. 26% - p = NS), no single event was significantly gender related. The logistic regression identified age and CRP concentration as the only predictive variables in the whole group. After splitting for genders, these parameters were still predictive of events in men. In women however, CRP was the only one with a borderline p value.

Conclusions: Our study does not support any gender difference for in-hospital adverse events in patients treated invasively for an acute coronary syndrome without ST-segment elevation and elevated troponin.

Show MeSH
Related in: MedlinePlus