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Effect of invasive strategy on different genders of chinese patients with non-ST-elevation myocardial infarction

Authors

  • Shao-Sung Huang MD,

    1. Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Department of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Ying-Hwa Chen MD, PhD,

    Corresponding author
    1. Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Department of Medicine, National Yang-Ming University, Taipei, Taiwan
    • Division of Cardiology, Taipei-Veterans General Hospital, No. 201 Sec. 2, Shih-Pai Road, Taipei, Taiwan
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  • Tse-Min Lu MD,

    1. Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Tao-Cheng Wu MD, PhD,

    1. Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Min-Ji Charng MD, PhD,

    1. Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Jaw-Wen Chen MD,

    1. Department of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
    3. Institute and Department of Pharmacology, National Yang-Ming University, Taipei, Taiwan
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  • Ju-Pin Pan MD,

    1. Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Shing-Jong Lin MD, PhD

    1. Department of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
    3. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Conflict of interest: Nothing to report

Abstract

Objectives: The aim of this study was to determine the impact of in-hospital revascularization on different genders and to compare the gender difference in short- and long-term prognosis of Chinese patients with non-ST-elevation myocardial infarction (NSTEMI). Background: The benefit of invasive strategy between the genders of Asian ethnic populations with NSTEMI remains unclear. Methods: A total of 343 consecutive NSTEMI patients were enrolled, 104 (30%) of them were women. All patients were followed up for at least 3 years or until the occurrence of a major event. The primary end point was all-cause death. The secondary end point was the combined occurrence of death or myocardial (re-)infarction (MI). Results: The adjusted in-hospital and long-term clinical outcomes were similar between men and women. However, in-hospital revascularization significantly reduced long-term mortality and composite endpoint in men (P < 0.001), but not in women. After risk stratification by GRACE score, there was favorable effect of invasive strategy in high-risk women. In a multivariate Cox regression analysis, GRACE score (hazard ratio; HR, 1.017; P < 0.001) and in-hospital revascularization (HR, 0.516; P = 0.008) were the independent predictors of death or MI in men. However, only GRACE score was the independent predictor of composite endpoint in women (HR, 1.012; P = 0.004). Conclusions: In Asian ethnic patients with NSTEMI, the in-hospital and long-term prognosis were similar between men and women. In-hospital revascularization has a benefit in men and high-risk women for reducing the all-cause death at 1 and 3 years. Our data provide evidence supporting the guideline recommendation for an invasive strategy in high-risk women. © 2011 Wiley Periodicals, Inc.

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