Role of Age and Sex in Short-term Mortality After STEMI in Eastern Europe: the ISACS-TC Initiative

Introduction: Previous works have shown that women hospitalized with STEMI have higher short-term mortality rates than men. However, it is unclear if these differences persist among patients undergoing contemporary primary PCI. Hypothesis: We sought to investigate whether the risk of in-hospital death after STEMI is higher in women than men and, if so, to assess the role of age, medications and primary PCI in this excess of risk. Methods: From January 2010 to May 2014, a total of 6690 patients have been hospitalized and received medical treatment for STEMI in 57 hospitals, referring data to the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC) registry (NCT01218776). Logistic regression model was adjusted to covariates significantly different between groups in univariate analysis. The endpoint was in-hospital mortality after STEMI. Results: There were 2070 women and 4620 men. Women were older than man, with a higher prevalence of risk factors and comorbidities. Fewer women than men presented within 2 hours from symptom onset (p<0.001). They presented more (p<0.001) Killip class ≥ 2 than men A significantly (p<0.001) lower proportion of women was treated with acute medications, secondary prevention therapies and primary PCI. The in-hospital mortality was significantly higher for women than for men (12.8% versus 6.9%, p<0.001). The gap in sex-specific mortality narrowed if restricting the analysis to men and women undergoing primary PCI (7.1% versus 3.5%, p