한국인 급성 심근경색증 등록 연구에서 성별에 따른 임상적 특징과 초기 치료의 차이

Abstract

Background and Objectives The first on-line registration of Korea Acute Myocardial Infarction patients (KAMIRs) has been carried out throughout the 41 primary percutaneous coronary intervention (PCI) centers that are supported by the Korean Circulation Society (KCS), as reported in the memorandum of the 50th Anniversary of the KCS.

Subjects and Methods Between Nov 2005 and June 2006, 4905 patients were enrolled in KAMIR and 4110 eligible patients (2855 males and 1255 females; mean age=64.3±13.5 years) were analyzed. The treatment strategy for acute myocardial infarction (AMI) was analyzed according to the gender differences in the area of acute ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI).

Results For the initial selection of a treatment strategy for STEMI, primary PCI was more commonly performed in males than females (69.8% vs. 68.3%, respectively, p=0.008), but age was the most important predictors after multivariate adjustment. During the hospital stay, PCI regardless of its subtype was more commonly done in the males than in the females with both STEMI and NSTEMI (STEMI: 89.1% vs. 84.9%, respectively, p=0.004; NSTEMI: 74.7% vs. 63.5%, respectively, p<0.001). The success rate of PCI in STEMI patients was not different between the genders (95.0% vs. 93.6%, respectively, p=0.399), but that of NSTEMI was higher in the males than the females (96.9% vs. 95.8%, respectively, p=0.004).

Conclusion For the initial treatment of AMI in Korea, females are treated more conservatively than males, but age was the most important predictor for invasive treatment. The success rate of PCI was higher for the males than the females.