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Gender differences in early invasive strategy after cardiac arrest: Insights from the PROCAT registry
- Source :
- Resuscitation. 114
- Publication Year :
- 2016
-
Abstract
- Early invasive strategy, including percutaneous coronary intervention (PCI), may improve survival in out-of-hospital-cardiac-arrest (OHCA) due to coronary artery disease but selection of suitable patients is challenging. Differences and results across gender remain unknown. We aimed to assess the relationship between gender and the use of an early invasive strategy after OHCA, and the relationship with outcome according to gender.All patients admitted after OHCA were prospectively included (2000-2013). Using a gender-independent algorithm for its indication, we assessed the association between the use of an early invasive strategy and the outcome at hospital discharge (using the Cerebral Performance Category scale), according to gender.1817 patients were included (520 women, 29%). Women were older (62.8 vs 59.1 years, P0.0001). They had less shockable rhythm (42% vs 61%, P0.001). After multivariate logistic regression, female gender was negatively associated with early coronary angiogram (OR=0.57, 95%CI 0.41-0.79, P=0.001). Results after propensity-score matching were consistent (P=0.02). Among 1157 patients who underwent coronary angiogram, rates of PCI did not differ between men and women (adjusted OR=1.26, 95%CI 0.87-1.82, P=0.23). Early invasive strategy was associated with favorable outcome in multivariate logistic regression (OR=1.43, 95%IC 1.02-2.0, P=0.04) with no interaction between gender and PCI (P for interaction=0.11). Association between PCI and outcome was consistent across genders.After OHCA, women are less likely to undergo early invasive strategy. However, rates of PCI after coronary angiogram do not differ across gender, and the association between PCI and outcome is similar across gender.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
030204 cardiovascular system & hematology
Emergency Nursing
Return of spontaneous circulation
Coronary Angiography
Sudden death
Time-to-Treatment
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Sex Factors
Medicine
Humans
Cardiopulmonary resuscitation
Prospective Studies
Registries
Sex Distribution
Intensive care medicine
Prospective cohort study
Propensity Score
Aged
business.industry
Percutaneous coronary intervention
030208 emergency & critical care medicine
Middle Aged
medicine.disease
Logistic Models
Treatment Outcome
Propensity score matching
Conventional PCI
Emergency medicine
Emergency Medicine
Female
Cardiology and Cardiovascular Medicine
business
Out-of-Hospital Cardiac Arrest
Subjects
Details
- ISSN :
- 18731570
- Volume :
- 114
- Database :
- OpenAIRE
- Journal :
- Resuscitation
- Accession number :
- edsair.doi.dedup.....c364f25314892c2734f5851f5dd8968d