{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T07:16:21Z","timestamp":1782544581303,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,9,2]],"date-time":"2014-09-02T00:00:00Z","timestamp":1409616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2015,2,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Studies have shown sex\u2010based disparities in ST\u2010segment elevation myocardial infarction (STEMI) management and prognosis. We sought to compare women and men undergoing primary percutaneous coronary intervention (PCI) for STEMI in a large, prospective, contemporary context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS\u2010AMI) trial randomized 3,602 patients (23.4% women and 76.6% men) with STEMI presenting within 12 hr of onset of symptoms to bivalirudin or heparin plus glycoprotein IIb\/IIIa inhibitors and to PCI with drug\u2010eluting or bare metal stents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with men, women presented later after symptom onset and were more often treated with medical management alone (6.9% vs. 4.7%; <jats:italic>P<\/jats:italic>\u2009=\u20090.01). Women had significantly higher rates of 3\u2010year major adverse cardiac events (MACE) and major bleeding. After adjusting for baseline differences, female sex remained an independent predictor of major bleeding (hazard ratio [HR] 1.81, 95% confidence interval [CI] 1.41\u20132.33; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) but not of MACE (HR 1.09; 95% CI 0.91\u20131.32; <jats:italic>P<\/jats:italic>\u2009=\u20090.35).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study found that women with STEMI are at increased risk of bleeding as compared to men. While female sex may not directly contribute to increased risk of MACE, it is, however, associated with the presence of comorbidities that increase the risk of ischemic events long\u2010term. Further dedicated studies are needed to confirm these findings and to assess strategies to optimize both the initial emergent treatment and long\u2010term management in this high\u2010risk subset. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.25630","type":"journal-article","created":{"date-parts":[[2014,8,13]],"date-time":"2014-08-13T00:24:30Z","timestamp":1407889470000},"page":"359-368","source":"Crossref","is-referenced-by-count":88,"title":["Sex\u2010based differences in bleeding and long term adverse events after percutaneous coronary intervention for acute myocardial infarction: Three year results from the HORIZONS\u2010AMI trial"],"prefix":"10.1002","volume":"85","author":[{"given":"Jennifer","family":"Yu","sequence":"first","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai New York New York"},{"name":"Prince of Wales Clinical School Randwick New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai New York New York"},{"name":"Cardiovascular Research Foundation New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Grinfeld","sequence":"additional","affiliation":[{"name":"Hospital Italiano  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Xu","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"Nikolsky","sequence":"additional","affiliation":[{"name":"Rambam Health Care Campus and the Technion \u2013 Israel Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce R.","family":"Brodie","sequence":"additional","affiliation":[{"name":"LeBauer Cardiovascular Research Foundation and Moses Cone Heart and Vascular Center Greensboro North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Witzenbichler","sequence":"additional","affiliation":[{"name":"Helios Amper\u2010Klinikum  Dachau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Kornowski","sequence":"additional","affiliation":[{"name":"Rabin Medical Center  Petach\u2010Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George D.","family":"Dangas","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai New York New York"},{"name":"Cardiovascular Research Foundation New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra J.","family":"Lansky","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine 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