Gender Disparities in Management and Outcomes of STEMI Patients Undergoing Primary PCI: A Single-Center Experience.

Abstract

Background: Gender-based differences in the clinical presentation, angiographic findings, and outcomes of ST-elevation myocardial infarction (STEMI) are increasingly recognized worldwide. However, region-specific data, especially from South Asian cardiac centres, remain limited. To evaluate gender-based differences in angiographic characteristics, procedural interventions, and in-hospital outcomes among STEMI patients undergoing primary percutaneous coronary intervention (PCI) at a tertiary cardiac centre.

Methodology: This retrospective study included 257 STEMI patients (194 males, 63 females) admitted between March and August 2024. Upon admission, all patients underwent diagnostic workup including ECG, troponin, myocardial enzymes, and other biochemical markers, followed by primary PCI. Comparative analysis was performed between male and female patients regarding baseline risk factors, angiographic patterns, procedural characteristics, and in-hospital adverse events.

Results: The mean age of male patients was 57.84 ± 10.83 years and female patients 59.31 ± 12.06 years. Smoking was reported only in males (14.43% vs. 0%), whereas females had significantly higher rates of hypertension (76.19% vs. 42.27%), diabetes mellitus (58.73% vs. 23.71%), and heart failure (20.63% vs. 10.31%). Anterior wall myocardial infarction (AWMI) was predominant among males, while inferior wall myocardial infarction (IWMI) was more common in females. The left anterior descending (LAD) artery was identified as the most frequent culprit vessel in both sexes. No significant differences were observed in procedural parameters; however, catheterization lab-related complications (p = 0.05) and in-hospital major adverse cardiac events (MACE) (p = 0.035) were significantly higher in female patients.

Conclusion: Female patients with STEMI present with a greater burden of cardiovascular comorbidities and experience higher in-hospital complication rates and MACE following primary PCI, despite a similar age of onset and angiographic profiles to their male counterparts. These findings underscore the importance of sex-specific risk stratification and post-PCI monitoring to improve outcomes in women.