Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Sex Differences of the Clinical Characteristics and Early Management in the Korea Acute Myocardial Infarction Registry

한국인 급성 심근경색증 등록 연구에서 성별에 따른 임상적 특징과 초기 치료의 차이

Lee, Ki-Hong;Ahn, Young-Keun;Kim, Jong-Hyun;Chae, Shung-Chull;Kim, Young-Jo;Hur, Seung-Ho;Seong, In-Whan;Hong, Taek-Jong;Choi, Dong-Hoon;Cho, Myeong-Chan;Kim, Chong-Jin;Seung, Ki-Bae;Chung, Wook-Sung;Jang, Yang-Soo;Cho, Jeong-Gwan;Park, Seung-Jung;other Korea Acute Myocardial Infarction Registry Investigators, other Korea Acute Myocardial Infarction Registry Investigators;Jeong, Myung-Ho
이기홍;안영근;김종현;채성철;김영조;허승호;성인환;홍택종;최동훈;조명찬;김종진;승기배;정욱성;장양수;조정관;박승정;한국인 급성 심근경색증 등록 연구자;정명호

  • Published : 2007.02.28
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Abstract

Background and Objectives：The first on-line registration of Korea Acute Myocardial Infarction patients (KAMIRs) has been carried out throughout the 41 primary percutaneous coronary intervention (PCI) centers that are supported by the Korean Circulation Society (KCS), as reported in the memorandum of the 50th Anniversary of the KCS. Subjects and Methods：Between Nov 2005 and June 2006, 4905 patients were enrolled in KAMIR and 4110 eligible patients (2855 males and 1255 females; mean age=64.3±13.5 years) were analyzed. The treatment strategy for acute myocardial infarction (AMI) was analyzed according to the gender differences in the area of acute ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI). Results：For the initial selection of a treatment strategy for STEMI, primary PCI was more commonly performed in males than females (69.8% vs. 68.3%, respectively, p=0.008), but age was the most important predictors after multivariate adjustment. During the hospital stay, PCI regardless of its subtype was more commonly done in the males than in the females with both STEMI and NSTEMI (STEMI: 89.1% vs. 84.9%, respectively, p=0.004; NSTEMI: 74.7% vs. 63.5%, respectively, p<0.001). The success rate of PCI in STEMI patients was not different between the genders (95.0% vs. 93.6%, respectively, p=0.399), but that of NSTEMI was higher in the males than the females (96.9% vs. 95.8%, respectively, p=0.004). Conclusion：For the initial treatment of AMI in Korea, females are treated more conservatively than males, but age was the most important predictor for invasive treatment. The success rate of PCI was higher for the males than the females. (Korean Circulation J 2007;37:64-71)

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References

  1. Kim IS. The present condition and trend of five major causes of death in Korean. Korean J Med Assoc 1995;38:132-45
  2. Suh I, Jee SH, Kim IS. Changing pattern of cardiovascular diseases in Korea. Korean J Epidemiol 1993;15:40-6
  3. Meischke H, Larsen MP, Eisenberg MS. Gender differences in reported symptoms for acute myocardial infarction: impact on prehospital delay time interval. Am J Emerg Med 1998;16:363-6 https://doi.org/10.1016/S0735-6757(98)90128-0
  4. Patel H, Rosengren A, Ekman I. Synptoms in acute coronary syndromes: does it make a difference? Am Heat J 2004;148:27-33 https://doi.org/10.1016/j.ahj.2004.03.005
  5. Kosuge M, Kimura K, Ishikawa T, et al. Differences between men and women in terms of clinical features of ST-segment elevation acute myocardial infarction. Circ J 2006;70:222-6 https://doi.org/10.1253/circj.70.222
  6. Vaccarino V, Parsons L, Every NR, Barron HV, Krumholtz HM. Sex-based differences in early mortality after myocardial infarction. N Engl J Med 1999;341:217-25 https://doi.org/10.1056/NEJM199907223410401
  7. Maynard C, Litwin PE, Martin JS, Weaver WD. Gender differences in the treatment and outcome of acute myocardial infarction. Arch Intern Med 1992;152:972-6 https://doi.org/10.1001/archinte.152.5.972
  8. Kostis JB, Wilson AC, O'Dowd K, et al. Sex differences in the management and long-term outcome of acute myocardial infarction: a statewide study: MIDAS Study Group: Myocardial Infarction Data Acquisition System. Circulation 1994;90:1715-30 https://doi.org/10.1161/01.CIR.90.4.1715
  9. Kudenchuk PJ, Maynard C, Martin JS, Wirkus M, Weaver WD. Comparison of presentation, treatment, and outcome of acute myocardial infarction in men versus women (the Myocardial Infarction Triage and Intervention Registry). Am J Cardiol 1996; 78:9-14
  10. Chandra NC, Ziegelstein RC, Rogers WJ, et al. Observations of the treatment of women in the United States with myocardial infarction: a report from the National Registry of Myocardial Infarction- I. Arch Intern Med 1998;158:981-8 https://doi.org/10.1001/archinte.158.9.981
  11. Tamis-Holland JE, Palazzo A, Stebbins AL, et al. Benefits of direct angioplasty for women and men with acute myocardial infarction: results of the Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes Angioplasty (GUSTO II-B) Angioplasty Substudy. Am Heart J 2004;147:133-9 https://doi.org/10.1016/j.ahj.2003.06.002
  12. Oe K, Shimizu M, Ino H, et al. Effects of gender on the number of diseased vessels and clinical outcome in Japanese patients with acute coronary syndrome. Circ J 2002;66:435-40 https://doi.org/10.1253/circj.66.435
  13. Fiebach HN, Viscoli CM, Horwitz RI. Differences between women and men in survival after myocardial infarction: biology or methodology? JAMA 1990;263:1092-6 https://doi.org/10.1001/jama.263.8.1092
  14. Gottlieb S, Moss AJ, McDermott M, Eberly S. Comparison of post hospital survival after acute myocardial infarction in women and men. Am J Cardiol 1994;74:727-30 https://doi.org/10.1016/0002-9149(94)90319-0
  15. Karlson BW, Herlitz J, Hartford M. Prognosis in myocardial infarction in relation to gender. Am Heart J 1994;128:477-83 https://doi.org/10.1016/0002-8703(94)90620-3
  16. Moon KW, Lee MY, Chung WS, et al. Sex differences in early management of patients with acute myocardial infarction in the 1990s. Korean Circ J 2003;33:85-91 https://doi.org/10.4070/kcj.2003.33.2.85
  17. Karlson BW, Hartford M, Herlitz J. Treatment of patients with acute myocardial infarction in relation to gender. Cardiology 1996;87:230-4 https://doi.org/10.1159/000177092
  18. Reina A, Colmenero M, Aguayo de Hoyos E, et al. Gender differences in management and outcome of patients with acute myocardial infarction. Int J Cardiol 2006. [Epub ahead of print]
  19. Oka RK, Fortmann SP, Varady AN. Differences in treatment of acute myocardial infarction by sex, age, and other factors (the Stanford Five-City Project). Am J Cardiol 1996;78:861-5 https://doi.org/10.1016/S0002-9149(96)00457-2
  20. Culic V, Eterovic D, Miric D, Silic N. Symptom presentation of acute myocardial infarction: influence of sex, age, and risk factors. Am Heart J 2002;144:1012-7 https://doi.org/10.1067/mhj.2002.125625
  21. Meischke H, Eisenberg MS, Schaeffer SM, Damon SK, Larsen MP, Henwood DK. Utilization of emergency medical services for symptoms of acute myocardial infarction. Heart Lung 1995;24: 11-8 https://doi.org/10.1016/S0147-9563(05)80090-1
  22. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction). Circulation 2004;110: e82-292
  23. Stone GW, Grines CL, Browne KF, et al. Comparison of in-hospital outcome in men versus women treated by either thrombolytic therapy or primary coronary angioplasty for acute myocardial infarction. Am J Cardiol 1995;75:987-92 https://doi.org/10.1016/S0002-9149(99)80709-7
  24. Mehilli J, Ndrepepa G , Kastrati A, et al. Gender and myocardial salvage after reperfusion treatment in acute myocardial infarction. J Am Coll Cardiol 2005;45:828-31 https://doi.org/10.1016/j.jacc.2004.11.054
  25. van't Hof A, Liem A, Suryapranata H, Hoorntje JC, de Boer MJ, Zijlstra F. Angiographic assessment of myocardial reperfusion in patients treated with primary angioplasty for acute myocardial infarction: myocardial blush grade. Circulation 1998;97:2302-6 https://doi.org/10.1161/01.CIR.97.23.2302
  26. Henriques JP, Zijlstra F, Ottervanger JP, et al. Incidence and clinical significance of distal embolization during primary angioplasty for acute myocardial infarction. Eur Heart J 2002;23:1112-7 https://doi.org/10.1053/euhj.2001.3035
  27. Morice MC, Serruys PW, Sousa JE, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revalscularization. N Engl J Med 2002;346:1773-80 https://doi.org/10.1056/NEJMoa012843
  28. Goy JJ, Urban P, Seydoux C, de Benedetti E, Stauffer JC. Use of sirolimus-eluting coronary stents in routine clinical practice. Catheter Cardiovasc Interv 2004;62:26-9 https://doi.org/10.1002/ccd.10744
  29. Park SJ, Shim WH, Ho DS, et al. A paclitaxel-eluting stent for the prevention of coronary restenosis. N Engl J Med 2003;348: 1537-45 https://doi.org/10.1056/NEJMoa021007
  30. Halkin A, Stone GW. Polymer-based paclitaxel-eluting stents in a percutaneous coronary intervention: a review of TAXUS trials. J Interv Cardiol 2004;17:271-82 https://doi.org/10.1111/j.1540-8183.2004.04040.x