Sex differences in time to primary percutaneous coronary intervention and outcomes in patients presenting with ST‐segment elevation myocardial infarction

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Abstract
Objectives: We assessed sex differences in treatment and outcomes in ST‐segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI).Background: Historically, delays to timely reperfusion and poorer outcomes have been described in women who suffer STEMI. However, whether these sex discrepancies still exist with contemporary STEMI treatment remains to be evaluated.Methods: Consecutive STEMI patients treated with primary PCI patients over a 10‐year period (January 1, 2010 to December 31, 2019) from a tertiary referral center were assessed. Comparisons were performed between patient's sex. Primary outcomes were 30‐day and 1‐year mortality. Secondary outcomes were STEMI performance measures.Results: Most patients (n = 950; 76%) were male. Females were on average older (66.8 vs. 61.4 years males; p < 0.001). Prehospital treatment delays did not differ between sexes (54 min [IQR: 44–65] females vs. 52 min [IQR: 43–62] males; p = 0.061). STEMI performance measures (door‐to‐balloon, first medical contact‐to‐balloon [FMCTB]) differed significantly with longer median durations in females and fewer females achieving FMCTB < 90 min (28% females vs. 39% males; p < 0.001). Women also experienced greater rates of initial radial arterial access failure (11.3% vs. 3.1%; p < 0.001). However, there were no significant sex differences in crude or adjusted mortality between sexes at 30‐days (3.6% male vs. 5.1% female; p = 0.241, adjusted OR: 1.1, 95% CI: 0.5–2.2, p = 0.82) or at 1‐year (4.8% male vs. 6.8% female; p = 0.190, adjusted OR: 1.0, (95% CI: 0.5–1.8; p = 0.96).Conclusion: Small discrepancies between sexes in measures of timely reperfusion for STEMI still exist. No significant sex differences were observed in either 30‐day or 1‐year mortality.

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