Background

Because no data are available, we compared the 3-year outcomes of patients with non-ST-elevation myocardial infarction (NSTEMI) based on sex and symptom-to-balloon time (SBT).

Methods

This study included 4910 patients who were divided into two groups based on SBT: SBT <48 h (n = 3,293, 67.1%) and SBT ≥48 h (n = 1,617, 32.9%). The primary outcome was all-cause death during the 3-year follow-up period. The secondary outcome was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction, or repeat coronary revascularization.

Results

After adjustment, the in-hospital mortality rates for males and females in the SBT <48 h and SBT ≥48 h groups were similar. During a 3-year follow-up period, females in the SBT<48 h group had significantly higher rates of all-cause death (adjusted hazard ratio [aHR], 1.482; P = 0.006), cardiac death (CD, aHR, 1.617; P = 0.009), and MACE (aHR, 1.268; P = 0.024) than those males in the same groups. Female and males in the SBT ≥48 h group did not differ significantly in the primary and secondary outcomes. In males, the rates of all-cause death (P = 0.008) and CD (P = 0.024) were significantly higher in the SBT ≥48 h group than in the SBT <48 h group.

Conclusions

This study has identified a higher 3-year mortality rate in female patients with NSTEMI and SBT <48 h compared to their male counterparts. As such, a more preventive approach may be required to reduce mortality in these female patients.

中文翻译：

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根据症状到球囊时间，性别差异对非 ST 段抬高型心肌梗死患者支架植入成功后 3 年结局的影响

背景

由于没有可用数据，我们根据性别和症状到球囊扩张时间 (SBT) 比较了非 ST 段抬高型心肌梗死 (NSTEMI) 患者的 3 年结局。

方法

该研究纳入了 4910 名患者，根据 SBT 分为两组：SBT <48 小时（n = 3,293，67.1%）和 SBT ≥48 小时（n = 1,617，32.9%）。主要结局是三年随访期间的全因死亡。次要结局是主要不良心脏事件（MACE），定义为全因死亡、复发性心肌梗死或重复冠状动脉血运重建。

结果

调整后，SBT<48h和SBT≥48h组中男性和女性的院内死亡率相似。在 3 年随访期间，SBT<48 小时组中的女性全因死亡率（调整后风险比 [aHR]，1.482；P = 0.006）、心源性死亡（CD、aHR，1.617）率显着较高。 ; P = 0.009) 和 MACE (aHR, 1.268; P = 0.024) 高于同一组中的男性。SBT≥48小时组中女性和男性的主要和次要结局没有显着差异。在男性中，SBT ≥48 h 组的全因死亡率 (P = 0.008) 和 CD (P = 0.024) 显着高于 SBT <48 h 组。

结论

这项研究发现，与男性患者相比，48 小时内发生 NSTEMI 且 SBT 的女性患者的 3 年死亡率更高。因此，可能需要采取更具预防性的方法来降低这些女性患者的死亡率。