The impact of gender on long-term mortality in patients with multivessel disease after primary percutaneous coronary intervention

Background Gender and complete revascularisation are known to affect mortality. The objective of this study was to analyse a gender difference in mortality with respect to complete revascularisation for multivessel disease after primary percutaneous coronary intervention (PPCI) in STelevation myocardial infarction (STEMI) patients. Method In a prospective consecutive cohort of 1472 patients presenting with STEMI for PPCI, between January 2006 and January 2010, 832 patients with multivessel disease were analysed. The primary outcome was long-term mortality. Results Median follow-up was 3.3 ± 1.2 years. Complete revascularisation was performed less in females than in males (30 vs. 38%; p = 0.04). At PPCI, women (27%, n = 221) were ± 10 years older (p = 0.001), had more hypertension, renal failure and symptoms of heart failure (all p < 0.01). Cumulative long-term mortality with incomplete revasculari-sation was higher in females (F: 30 vs. M: 15%, p = 0.01). After adjustment for baseline characteristics, complete revascularisation (0.84; 95% CI 0.54–1.32) and gender (1.11; 95% CI 0.73–1.69) lost significance. Also the gender-bycomplete revascularisation interaction was not significant at long term. In women, age under 60 years independently predicted higher mortality (HR 10.09; 95% CI 3.08–33.08; p < 0.001). Conclusion In STEMI patients with multivessel disease at PPCI, women under the age of 60 years had higher mortality, but in women olde