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Acute myocardial infarction in women: is there a sex disparity between door-to-balloon time and clinical outcomes?

Coronary artery disease (CAD) has traditionally been thought of as a disease that predominantly affects men. Women, however, are more likely than men to die from a myocardial infarction (MI). Despite increased awareness of heart disease in women and improved outcomes after percutaneous coronary intervention (PCI), women with MI have more mortality and delays to treatment than men. Although all of the reasons behind these differences are not clear, women presenting with MI are a more morbid patient population than their male counterparts. Women consistently demonstrate higher baseline risk, including older age, higher rates of diabetes mellitus (DM), hypertension (HTN) and congestive heart failure (CHF) [1–5] . This was initially demonstrated in trials conducted in the thrombolytic era, but has persisted in the current era of PCI [3,5] . Another source of sex disparity in ST-elevation MI (STEMI) management is delay to treatment. It is well established that the benefit of PCI over fibrinolytic therapy is lost with delay in administering treatment. A meta-regression analysis of 23 randomized controlled trials in 2003 showed that for every 10-minute delay in PCI (defined as the difference between door to balloon and door to needle), the favorable reduction in mortality is http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Cardiovascular Revascularization Medicine Elsevier
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