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Gender-related disparities of Percutaneous Coronary interventions in ST- elevation myocardial infarction: a retrospective chart review of 500 patients

Sleiman, Elsa; Hosry, Jeff; Caruana, Lisa; Schwartz, Moishe; Karam, Boutros; Tabet, Rabih; Salmane, Chadi; Kandov, Ruben; Royzman, Roman; Tamburrino, Frank; Lafferty, James
Door to balloon (DTB) time of primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) is a predictive indicator of outcomes and mortality. Traditional gender-related differences that existed in the provision of DTB in STEMI had been allegedly improving until recent controversial data showed re-emergence of longer DTB in females. The objective of our study was to compare circadian disparities in PCI for STEMI according to gender in our institution. We compared DTB and symptom to balloon (STB) as well as mortality outcomes in a registry of 514 patients. We studied 117 females and 397 males. Baseline characteristics and cardiovascular risk factors were similar among both populations. Men used more self-transportation (51% vs 38%) compared to women. Both had similar DTB median times; males 63 (47-79) min and females 61 (44-76) min. In addition, STB median times were also similar; males: 155 (116-264) min; and females 165 (115-261) min. Mortality outcomes at 1 month were comparable at 3% in males vs 0.9% in females (p=0.164). In a review of a tertiary care center in New York; we observed no gender differences in DTB and STB; endorsing the role of EMS transportation in eliminating disparities.
PMID: 32769483
ISSN: 1535-2811
CID: 4555832

A case of fatal fulminant myocarditis presenting as an acute ST-segment elevation myocardial infarction and persistent ventricular tachyarrhythmia associated with influenza A (H1N1) virus in a previously healthy pregnant woman

Ona, Mel A; Bashari, Daniel R; Tharayil, Zubin; Charlot, Aglae; Hoskins, Iffath; Timoney, Michael; Usmani, Shakeel; Royzman, Roman
Several studies have reported influenza A (H1N1) virus as a cause of fulminant myocarditis. We report the first fatal case of fulminant myocarditis presenting as an acute ST-segment elevation myocardial infarction and ventricular tachyarrhythmia associated with influenza A (H1N1) in a previously healthy pregnant woman. A 38-year-old Asian woman, gravida 3, para 1-0-1-1, presented with flu-like symptoms. Initially, she developed wide-complex tachycardia requiring several defibrillations and was later intubated. Electrocardiogram showed ST-segment elevation. Coronary angiogram was negative and a pulmonary angiogram ruled out pulmonary embolism. Fetal compromise was noted on the monitor, and the patient underwent an emergent cesarean section. She subsequently expired. Autopsy confirmed severe myocarditis. Further testing confirmed influenza A (H1N1) virus. This case of a rare, yet lethal, complication of H1N1 infection underscores the importance of increased awareness among health care professionals to provide pregnant women with vaccination and prompt treatment.
PMID: 23018755
ISSN: 0008-6312
CID: 248592