Prospective multi-center study of female patients with ST-elevation myocardial infarction in Liaoning province, China

Background In cardiology, it is controversial whether gender influences prognosis after acute myocardial infarction （MI）. We examined the 30-day and 1-year prognosis for female patients with ST-elevation myocardial infarction （STEMI） in Liaoning province, and we analyzed factors that influenced these outcomes. Methods This was a prospective, multicenter, observational study in which patient data were collected by questionnaire at the time of diagnosis and at approximately 30 days and 1 year later by telephone inquiries. Patients were diagnosed with STEMI between June 1, 2009 and June 1, 2010 at any of the 20 hospitals that gave treatment representative of current STEMI treatment in Liaoning Province. Unified follow-up questionnaire was used to visit the STEMI patients. Results We analyzed data from a total of 1429 consecutive patients with STEMI in Liaoning province. Female patients were older （70.0 vs. 60.3, P 〈0.001） and were less likely to receive emergency reperfusion therapy than male ones （39.2% vs. 58.0%, P 〈0.001）. Female gender was associated with higher unadjusted 30-day mortality rates （HR=2.118, 95%C/： 1.572-2.854, P 〈0.001） and higher unadjusted 1-year mortality rates （HR=2.174, 95%C/： 1.659-2.848, P 〈0.001）. Multivariate Cox regression analysis showed that female gender was not an independent predictor of 30-day mortality rates （HR=1.273, 95%C/： 0.929-1.745, P=0.133） nor of 1-year mortality rates （HR=1.112, 95%C/： 0.831-1.487, P=0.475）. Conclusions Women with STEMI appear to be at increased risk of 30-day and 1-year mortality compared with male STEMI patients, but this difference may be explained by older age and less frequent receipt of reperfusion therapy among the women.