Gender differences in health-related quality of life following ST-elevation myocardial infarction: women and men do not benefit from primary percutaneous coronary intervention to the same degree
Restricted accessResearch articleFirst published online February, 2007
Gender differences in health-related quality of life following ST-elevation myocardial infarction: women and men do not benefit from primary percutaneous coronary intervention to the same degree
There is limited evidence whether women benefit to the same degree as men from treatment of myocardial infarction with percutaneous coronary intervention (PCI) when compared to fibrinolysis. This study compares health-related quality of life (HRQoL) outcomes for men and women randomized to primary PCI and fibrinolysis.
Design
A questionnaire-based study in 1351 patients with ST-elevation myocardial infarction (STEMI), assessed at 1 and 12 months after the infarction.
Methods
HRQoL was measured with the Medical Outcomes Study Short Form (SF-36), the Hospital Anxiety and Depression Scale (HADS), Rose's angina and dyspnoea questionnaire and global QoL questions.
Results
Women had a worse score than men on all endpoints at 1 month and at several endpoints at 12 months. In analyses of gender differences in benefits of PCI 1 month after the STEMI, significant gender differences were found in the SF-36 mental component summary scale, with men having better scores after primary PCI and women having better scores after fibrinolysis (P = 0.03). At 12 months, similar gender differences in treatment benefit were found in the SF-36 scales for general health (P = 0.01), mental health (P < 0.01), and the mental component summary scale (P =0.01), as well as in the scales for anxiety (P = 0.04), depression (P = 0.02), and global quality of life (P < 0.01); men had better scores after primary-PCI and women had better scores after fibrinolysis.
BrezinkaVKittelF.Psychosocial factors of coronary heart disease in women: a review.Soc Sci Med1996; 42: 1351–1365.
2.
CollinsPStevensonJCMoscaL.Spotlight on gender.Cardiovasc Res2002; 53: 535–537.
3.
VakiliBAKaplanRCBrownDL.Sex-based differences in early mortality of patients undergoing primary angioplasty for first acute myocardial infarction.Circulation2001; 104: 3034–3038.
4.
JacobsAKJohnstonJMHavilandABrooksMMKelseySFHolmesDRJr. Improved outcomes for women undergoing contemporary percutaneous coronary intervention: a report from the National Heart, Lung, and Blood Institute Dynamic registry.J Am Coll Cardiol2002; 39: 1608–1614.
5.
KaplanKLFitzpatrickPCoxCShammasNWMarderVJ.Use of thrombolytic therapy for acute myocardial infarction: effects of gender and age on treatment rates.J Thromb Thrombolysis2002; 13: 21–26.
6.
LundRDuePModvigJHolsteinBEDamsgaardMTAndersenPK.Cohabitation and marital status as predictors of mortality – an eight year follow-up study.Soc Sci Med2002; 55: 673–679.
7.
KjaerTGyrd-HansenDWillaingI.Investigating patients' references for cardiac rehabilitation in Denmark.Int J Technol Assess Health Care2006; 22: 211–218.
8.
StoneGWGrinesCLBrowneKFMarcoJRothbaumDO'KeefeJ. Comparison of in-hospital outcome in men versus women treated by either thrombolytic therapy or primary coronary angioplasty for acute myocardial infarction.Am J Cardiol1995; 75: 987–992.
9.
GlaserRHerrmannHCMurphySADemopoulosLADiBattistePMCannonCP. Benefit of an early invasive management strategy in women with acute coronary syndromes.JAMA2002; 288: 3124–3129.
10.
AndersenHRNielsenTTRasmussenKThuesenLKelbaekHThayssenP. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction.N Engl J Med2003; 349: 733–742.
11.
MortensenOSBjornerJBOldenburgBNewmanBGroenvoldMMadsenJK. Health-related quality of life one month after thrombolysis or primary PCI in patients with ST-elevation infarction. A DANAMI-2 sub-study.Scand Cardiovasc J2005; 39: 206–212.
12.
WengerNK.Assessment of quality of life in clinical trials of cardiovascular therapies.New York: Le Jacq; 1984.
13.
WareJEJrSherbourneCD.The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.Med Care1992; 30: 473–483.
14.
WareJE.SF-36 health survey manual and interpretation guide.Boston MA: The Health Institute; 1993.
15.
WareJE.SF-36 physical and mental health summary scales: a user's manual.Boston, MA: The Health Institute; 1994.
16.
BjornerJBThunedborgKKristensenTSModvigJBechP.The Danish SF-36 Health Survey: translation and preliminary validity studies.J Clin Epidemiol1998; 51: 991–999.
17.
RoseGMcCartneyPReidDD.Self-administration of a questionnaire on chest pain and intermittent claudication.Br J Prev Soc Med1977; 31: 42–48.
18.
RoseGABlackburnH.Cardiovascular survey methods.Monogr Ser World Health Organ1968; 56: 1–188.
19.
ZigmondASSnaithRP.The hospital anxiety and depression scale.Acta Psychiatr Scand1983; 67: 361–370.
20.
RinfretSGrinesCLCosgroveRSHoKKCoxDABrodieBR. Quality of life after balloon angioplasty or stenting for acute myocardial infarction. One-year results from the Stent-PAMI trial.J Am Coll Cardiol2001; 38: 1614–1621.
21.
ZijlstraFHoorntjeJCDe BoerMJReiffersSMiedemaKOttervangerJP. Long-term benefit of primary angioplasty as compared with thrombolytic therapy for acute myocardial infarction.N Engl J Med1999; 341: 1413–1419.
22.
HarroldLREstebanJLessardDYarzebskiJGurwitzJHGoreJM. Narrowing gender differences in procedure use for acute myocardial infarction: insights from the Worcester heart attack study.J Gen Intern Med2003; 18: 423–431.
23.
GanSCBeaverSKHouckPMMacLehoseRFLawsonHWChanL.Treatment of acute myocardial infarction and 30-day mortality among women and men.N Engl J Med2000; 343: 8–15.
24.
RathoreSSFoodyJMRadfordMJKrumholzHM.Sex differences in use of coronary revascularization in elderly patients after acute myocardial infarction: a tale of two therapies.Chest2003; 124: 2079–2086.
25.
TjandrawidjajaMCFuYGoodmanSGVan deWFGrangerCBArmstrongPW.The impact of gender on the treatment and outcomes of patients with early reinfarction after fibrinolysis: insights from ASSENT-2.Eur Heart J2003; 24: 1024–1034.
26.
KusterGMBuserPOsswaldSKaiserCSchonenbergerRSchindlerC. Comparison of presentation, perception, and six-month outcome between women and men ≥ 75 years of age with angina pectoris.Am J Cardiol2003; 91: 436–439.
27.
PetersonEDLanskyAJKramerJAnstromKLanzilottaMJ.Effect of gender on the outcomes of contemporary percutaneous coronary intervention.Am J Cardiol2001; 88: 359–364.
28.
NathFCMullerDWEllisSGRosenscheinUChapekisAQuainL. Thrombosis of a flexible coil coronary stent: frequency, predictors and clinical outcome.J Am Coll Cardiol1993; 21: 622–627.
29.
CheneauELeborgneLMintzGSKotaniJPichardADSatlerLF. Predictors of subacute stent thrombosis: results of a systematic intravascular ultrasound study.Circulation2003; 108: 43–47.
