STEMI Outcomes Improve For Both Genders, But More So For Men Interview with:
Dr. Stefano Savonitto 

Director, Division of Cardiology
Manzoni Hospital What is the background for this study? What are the main findings?

Response: Over the last 15 years, there has been a shift from fibrinolytic therapy for STEMI to primary angioplasty, which required a re-organization of the whole STEMI treatment network. Besides the higher reperfusion efficiency of primary angioplasty, as compared to lytic therapy, it has been a global upgrade of the STEMI care system that has reduced the rate of no reperfusion.

Elderly patients and women (who are, on average, also older than men) had theoretically the most to gain from this shift, but little data were available to assess this benefit.

In the present paper, we have shown that “lack of reperfusion” was reduced dramatically across all age groups and in both sexes, with a progressive and uniform increase in primary angioplasty, and a significant reduction in mortality. Almost as expected, elderly women were the category with the most relevant mortality benefit.

Nevertheless, after adjustment for age and other confounders, women continue to experience a higher mortality as compared to men. In the discussion of the paper, we propose some hypotheses for this persistently higher mortality in women. What should readers take away from your report?

The good news: STEMI mortality reduction in both sexes and at all ages.

The bad news: the persistently higher mortality in women, as compared to men. What recommendations do you have for future research as a result of this study?

Response: Particularly elderly women should be a matter for future research: they are, indeed, more fragile, and more prone to complications, both from drugs and from invasive procedures Is there anything else you would like to add?

Response: Thank you for the attention paid to our research. Thank you for your contribution to the community.


Contemporary Trends and Age-Specific Sex Differences in Management and Outcome for Patients With ST-Segment Elevation Myocardial Infarction.

De Luca L, Marini M, Gonzini L, Boccanelli A, Casella G, Chiarella F, De Servi S, Di Chiara A, Di Pasquale G, Olivari Z, Caretta G, Lenatti L, Gulizia MM, Savonitto S.

J Am Heart Assoc. 2016 Nov 23;5(12). pii: e004202.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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