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Clinical Profiles, Outcomes, and Sex Differences of Patients With STEMI: Findings From the NORIN-STEMI Registry

BACKGROUND: Low- and middle-income countries account for most of the global burden of coronary artery disease. There is a paucity of data regarding epidemiology and outcomes for ST-segment elevation myocardial infarction (STEMI) patients in these regions. OBJECTIVES: The authors studied the contempo...

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Autores principales: Qamar, Arman, Bhatia, Kirtipal, Arora, Sameer, Hendrickson, Michael, Gupta, Puneet, Fatima, Amber, MP, Girish, Bansal, Ankit, Batra, Vishal, Ricciardi, Mark J., Grines, Cindy L., Yusuf, Jamal, Mukhopadhyay, Saibal, Smith, Sidney C., Tyagi, Sanjay, Bhatt, Deepak L., Gulati, Martha, Gupta, Mohit D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308105/
https://www.ncbi.nlm.nih.gov/pubmed/37396424
http://dx.doi.org/10.1016/j.jacasi.2022.12.011
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author Qamar, Arman
Bhatia, Kirtipal
Arora, Sameer
Hendrickson, Michael
Gupta, Puneet
Fatima, Amber
MP, Girish
Bansal, Ankit
Batra, Vishal
Ricciardi, Mark J.
Grines, Cindy L.
Yusuf, Jamal
Mukhopadhyay, Saibal
Smith, Sidney C.
Tyagi, Sanjay
Bhatt, Deepak L.
Gulati, Martha
Gupta, Mohit D.
author_facet Qamar, Arman
Bhatia, Kirtipal
Arora, Sameer
Hendrickson, Michael
Gupta, Puneet
Fatima, Amber
MP, Girish
Bansal, Ankit
Batra, Vishal
Ricciardi, Mark J.
Grines, Cindy L.
Yusuf, Jamal
Mukhopadhyay, Saibal
Smith, Sidney C.
Tyagi, Sanjay
Bhatt, Deepak L.
Gulati, Martha
Gupta, Mohit D.
author_sort Qamar, Arman
collection PubMed
description BACKGROUND: Low- and middle-income countries account for most of the global burden of coronary artery disease. There is a paucity of data regarding epidemiology and outcomes for ST-segment elevation myocardial infarction (STEMI) patients in these regions. OBJECTIVES: The authors studied the contemporary characteristics, practice patterns, outcomes, and sex differences in patients with STEMI in India. METHODS: NORIN-STEMI (North India ST-Segment Elevation Myocardial Infarction Registry) is an investigator-initiated prospective cohort study of patients presenting with STEMI at tertiary medical centers in North India. RESULTS: Of 3,635 participants, 16% were female patients, one-third were <50 years of age, 53% had a history of smoking, 29% hypertension, and 24% diabetes. The median time from symptom onset to coronary angiography was 71 hours; the majority (93%) presented first to a non-percutaneous coronary intervention (PCI)-capable facility. Almost all received aspirin, statin, P2Y(12) inhibitors, and heparin on presentation; 66% were treated with PCI (98% femoral access) and 13% received fibrinolytics. The left ventricular ejection fraction was <40% in 46% of patients. The 30-day and 1-year mortality rates were 9% and 11%, respectively. Compared with male patients, female patients were less likely to receive PCI (62% vs 73%; P < 0.0001) and had a more than 2-fold greater 1-year mortality (22% vs 9%; adjusted HR: 2.1; 95% CI: 1.7-2.7; P < 0.001). CONCLUSIONS: In this contemporary registry of patients with STEMI in India, female patients were less likely to receive PCI after STEMI and had a higher 1-year mortality compared with male patients. These findings have important public health implications, and further efforts are required to reduce these gaps.
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spelling pubmed-103081052023-06-30 Clinical Profiles, Outcomes, and Sex Differences of Patients With STEMI: Findings From the NORIN-STEMI Registry Qamar, Arman Bhatia, Kirtipal Arora, Sameer Hendrickson, Michael Gupta, Puneet Fatima, Amber MP, Girish Bansal, Ankit Batra, Vishal Ricciardi, Mark J. Grines, Cindy L. Yusuf, Jamal Mukhopadhyay, Saibal Smith, Sidney C. Tyagi, Sanjay Bhatt, Deepak L. Gulati, Martha Gupta, Mohit D. JACC Asia Original Research BACKGROUND: Low- and middle-income countries account for most of the global burden of coronary artery disease. There is a paucity of data regarding epidemiology and outcomes for ST-segment elevation myocardial infarction (STEMI) patients in these regions. OBJECTIVES: The authors studied the contemporary characteristics, practice patterns, outcomes, and sex differences in patients with STEMI in India. METHODS: NORIN-STEMI (North India ST-Segment Elevation Myocardial Infarction Registry) is an investigator-initiated prospective cohort study of patients presenting with STEMI at tertiary medical centers in North India. RESULTS: Of 3,635 participants, 16% were female patients, one-third were <50 years of age, 53% had a history of smoking, 29% hypertension, and 24% diabetes. The median time from symptom onset to coronary angiography was 71 hours; the majority (93%) presented first to a non-percutaneous coronary intervention (PCI)-capable facility. Almost all received aspirin, statin, P2Y(12) inhibitors, and heparin on presentation; 66% were treated with PCI (98% femoral access) and 13% received fibrinolytics. The left ventricular ejection fraction was <40% in 46% of patients. The 30-day and 1-year mortality rates were 9% and 11%, respectively. Compared with male patients, female patients were less likely to receive PCI (62% vs 73%; P < 0.0001) and had a more than 2-fold greater 1-year mortality (22% vs 9%; adjusted HR: 2.1; 95% CI: 1.7-2.7; P < 0.001). CONCLUSIONS: In this contemporary registry of patients with STEMI in India, female patients were less likely to receive PCI after STEMI and had a higher 1-year mortality compared with male patients. These findings have important public health implications, and further efforts are required to reduce these gaps. Elsevier 2023-04-04 /pmc/articles/PMC10308105/ /pubmed/37396424 http://dx.doi.org/10.1016/j.jacasi.2022.12.011 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Qamar, Arman
Bhatia, Kirtipal
Arora, Sameer
Hendrickson, Michael
Gupta, Puneet
Fatima, Amber
MP, Girish
Bansal, Ankit
Batra, Vishal
Ricciardi, Mark J.
Grines, Cindy L.
Yusuf, Jamal
Mukhopadhyay, Saibal
Smith, Sidney C.
Tyagi, Sanjay
Bhatt, Deepak L.
Gulati, Martha
Gupta, Mohit D.
Clinical Profiles, Outcomes, and Sex Differences of Patients With STEMI: Findings From the NORIN-STEMI Registry
title Clinical Profiles, Outcomes, and Sex Differences of Patients With STEMI: Findings From the NORIN-STEMI Registry
title_full Clinical Profiles, Outcomes, and Sex Differences of Patients With STEMI: Findings From the NORIN-STEMI Registry
title_fullStr Clinical Profiles, Outcomes, and Sex Differences of Patients With STEMI: Findings From the NORIN-STEMI Registry
title_full_unstemmed Clinical Profiles, Outcomes, and Sex Differences of Patients With STEMI: Findings From the NORIN-STEMI Registry
title_short Clinical Profiles, Outcomes, and Sex Differences of Patients With STEMI: Findings From the NORIN-STEMI Registry
title_sort clinical profiles, outcomes, and sex differences of patients with stemi: findings from the norin-stemi registry
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308105/
https://www.ncbi.nlm.nih.gov/pubmed/37396424
http://dx.doi.org/10.1016/j.jacasi.2022.12.011
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