Author + information
- Ziad Sergie,
- Roxana Mehran,
- Sorin Brener,
- Akiko Maehara,
- Martin Fahy,
- Uwe Zeymer,
- Azfar Zaman,
- Jochen Woehrle,
- C. Michael Gibson and
- Gregg Stone
It is unclear whether gender differences exist in cardiac symptoms after percutaneous coronary intervention (PCI) for ST–segment elevation myocardial infarction (STEMI).
The INFUSE–AMI trial randomized patients with anterior STEMI due to proximal or mid left anterior descending occlusion to intracoronary abciximab delivered via the ClearWay™ RX catheter vs no abciximab, and to manual thrombus aspiration with the Export® catheter vs no aspiration. We compared 30–day infarct size on cardiac magnetic resonance imaging in women and men. We also analyzed the 30–day rates of self–reported angina (Canadian Cardiovascular Society; CCS scale) and heart failure (HF; NYHA scale) by gender.
Among 452 patients, 118 (26.1%) were female and the average age was 61 years. Women were older than men and more often had hypertension, hyperlipidemia, and heart failure. Women experienced a greater delay from symptom onset to hospital arrival (median 137.4 vs 106.8 min, P<0.0001) and in door–to–device time (median 60 vs 51.6 min, P=0.04) than men. The post–procedure and 30–day outcomes in both groups are shown in Table 1.
In this trial, women experienced more angina (CCS I) and dyspnea (NYHA I–III) in the first month after primary PCI despite state of the art interventions and similar reperfusion success and infarct size. Whether these differences are related to baseline characteristics, disease perception or underlying microvascular disease in women deserves further study.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Coronary Stents
Abstract Category: 47. TCT@ACC–i2: Coronary Intervention, Devices
Presentation Number: 2101–234
- 2013 American College of Cardiology Foundation