SEX-BASED DIFFERENCES IN SHORT TERM SURVIVAL AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION: THE ROLE OF SYSTEM DELAY

Background: Conflicting information exists on sex based differences in outcomes after pPCI. Worse outcomes after pPCI in women may be due to delay in presentation Methods: We, investigated the relationship among sex, prehospital delays and risks of adverse short clinical outcomes after pPCI using the ISACS-TC (NCT01218776) registry from 2010 - 2015. The study populations consisted of 6679 pts with STEMI who had pPCI within 24h of symptom onset. Multivariate logistic regression models were adjusted to covariates significantly different between groups in univariate analysis.The primary endpoint was 30 day mortality Results: Compared with a hospital admission greater than 2h, a time of 2h or less was associated with a lower incidence of death (6.5% vs 8.9%). Admission delays >2h were significantly more frequent in women than in men (67.7% vs 32.3%). There were no significant sex differences in door to balloon times (median: 45 vs 45 min). Unadjusted 30 days mortality was significantly higher in women than men (12.2% vs 6.6%). After multivariable adjustment, women remained significantly associated with a higher risk of death, OR: 1.33 CI 1.07- 1.66. Sex differences were no longer observed in the cohort, when the analysis was restricted to patients with hospital admission ≤2h, OR 0.89 CI 0.52-1.53 Conclusions: Among patients undergoing pPCI, women have a significantly higher risk of short-term mortality than men.