Trends in outcomes of women with myocardial infarction undergoing primary angioplasty-Analysis of randomized trials.

mortality myocardial infarction outcome primary PCI therapy management trends women

Journal

Frontiers in cardiovascular medicine
ISSN: 2297-055X
Titre abrégé: Front Cardiovasc Med
Pays: Switzerland
ID NLM: 101653388

Informations de publication

Date de publication:
2022
Historique:
received: 26 05 2022
accepted: 07 12 2022
entrez: 23 1 2023
pubmed: 24 1 2023
medline: 24 1 2023
Statut: epublish

Résumé

Sex- and gender-associated differences determine the disease response to treatment. The study aimed to explore the hypothesis that progress in the management of STE-myocardial infarction (STEMI) overcomes the worse outcome in women. We performed an analysis of three randomized trials enrolling patients treated with primary PCI more than 10 years apart. PRAGUE-1,-2 validated the preference of transport for primary PCI over on-site fibrinolysis. PRAGUE-18 enrollment was ongoing at the time of the functional network of 24/7PCI centers, and the intervention was supported by intensive antiplatelets. The proportion of patients with an initial Killip ≥ 3 was substantially higher in the more recent study (0.6 vs. 6.7%, The prognosis of women with MI treated with primary PCI improved substantially with 24/7 regional availability of mechanical reperfusion, performance-enhancing technical progress, and intensive adjuvant antithrombotic therapy. A major modifiable hindrance to achieving this benefit in a broad population of women is the timely diagnosis by health professional services.

Sections du résumé

Background UNASSIGNED
Sex- and gender-associated differences determine the disease response to treatment.
Aim UNASSIGNED
The study aimed to explore the hypothesis that progress in the management of STE-myocardial infarction (STEMI) overcomes the worse outcome in women.
Methods and results UNASSIGNED
We performed an analysis of three randomized trials enrolling patients treated with primary PCI more than 10 years apart. PRAGUE-1,-2 validated the preference of transport for primary PCI over on-site fibrinolysis. PRAGUE-18 enrollment was ongoing at the time of the functional network of 24/7PCI centers, and the intervention was supported by intensive antiplatelets. The proportion of patients with an initial Killip ≥ 3 was substantially higher in the more recent study (0.6 vs. 6.7%,
Conclusion UNASSIGNED
The prognosis of women with MI treated with primary PCI improved substantially with 24/7 regional availability of mechanical reperfusion, performance-enhancing technical progress, and intensive adjuvant antithrombotic therapy. A major modifiable hindrance to achieving this benefit in a broad population of women is the timely diagnosis by health professional services.

Identifiants

pubmed: 36684569
doi: 10.3389/fcvm.2022.953567
pmc: PMC9845716
doi:

Types de publication

Journal Article

Langues

eng

Pagination

953567

Informations de copyright

Copyright © 2023 Motovska, Hlinomaz, Aschermann, Jarkovsky, Želízko, Kala, Groch, Svoboda, Hromadka and Widimsky.

Déclaration de conflit d'intérêts

JJ was employed by Institute of Biostatistics and Analyses Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Zuzana Motovska (Z)

Cardiocentre, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia.

Ota Hlinomaz (O)

Department of Cardioangiology, International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia.

Michael Aschermann (M)

Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czechia.

Jiri Jarkovsky (J)

Institute of Biostatistics and Analyses Ltd., Faculty of Medicine, Masaryk University, Brno, Czechia.

Michael Želízko (M)

Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czechia.

Petr Kala (P)

Department of Internal and Cardiology, Faculty of Medicine, Masaryk University and University Hospital Brno-Bohunice, Brno, Czechia.

Ladislav Groch (L)

Department of Cardioangiology, International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czechia.

Michal Svoboda (M)

Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czechia.

Milan Hromadka (M)

Department of Cardiology, Charles University, University Hospital in Pilsen, Pilsen, Czechia.

Petr Widimsky (P)

Cardiocentre, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia.

Classifications MeSH