{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:43:33Z","timestamp":1780533813290,"version":"3.54.1"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T00:00:00Z","timestamp":1646611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Hypothesis<\/jats:title><jats:p>Two cohorts face high mortality after ST\u2010elevation myocardial infarction (STEMI): females and patients with in\u2010hospital STEMI. The aim of this study was to evaluate sex differences in ischemic times and outcomes of in\u2010hospital STEMI patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive STEMI patients treated with percutaneous coronary intervention (PCI) were prospectively recruited from 30 hospitals into the Victorian Cardiac Outcomes Registry (2013\u22122018). Sex discrepancies within in\u2010hospital STEMIs were compared with out\u2010of\u2010hospital STEMIs. The primary endpoint was 12\u2010month all\u2010cause mortality. Secondary endpoints included symptom\u2010to\u2010device (STD) time and 30\u2010day major adverse cardiovascular events (MACE). To investigate the relationship between sex and 12\u2010month mortality for in\u2010hospital versus out\u2010of\u2010hospital STEMIs, an interaction analysis was included in the multivariable models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 7493 STEMI patients underwent PCI of which 494 (6.6%) occurred in\u2010hospital. In\u2010hospital versus out\u2010of\u2010hospital STEMIs comprised 31.9% and 19.9% females, respectively. Female in\u2010hospital STEMIs were older (69.5 vs. 65.9 years, <jats:italic>p<\/jats:italic>\u2009=\u2009.003) with longer adjusted geometric mean STD times (104.6 vs. 94.3\u2009min, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) than men. Female versus male in\u2010hospital STEMIs had no difference in 12\u2010month mortality (27.1% vs. 20.3%, <jats:italic>p<\/jats:italic>\u2009=\u2009.92) and MACE (22.8% vs. 19.3%, <jats:italic>p<\/jats:italic>\u2009=\u2009.87). Female sex was not independently associated with 12\u2010month mortality for in\u2010hospital STEMIs which was consistent across the STEMI cohort (OR: 1.26, 95% CI: 0.94\u20131.70, <jats:italic>p<\/jats:italic>\u2009=\u2009.13).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In\u2010hospital STEMIs are more frequent in females relative to out\u2010of\u2010hospital STEMIs. Despite already being under medical care, females with in\u2010hospital STEMIs experienced a 10\u2010min\u00a0mean excess in STD time compared with males, after adjustment for confounders. Adjusted 12\u2010month mortality and MACE were similar to males.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23797","type":"journal-article","created":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T09:13:39Z","timestamp":1646644419000},"page":"427-434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Sex differences in treatment and outcomes of patients with in\u2010hospital ST\u2010elevation myocardial infarction"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3089-1062","authenticated-orcid":false,"given":"Julia","family":"Stehli","sequence":"first","affiliation":[{"name":"Nursing and Health Sciences,\u00a0Faculty of Medicine Monash University Melbourne Victoria Australia"},{"name":"Epworth HealthCare Richmond Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diem","family":"Dinh","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Centre of Cardiovascular Research and Education in Therapeutics Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misha","family":"Dagan","sequence":"additional","affiliation":[{"name":"Department of General Medicine The Alfred Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Dick","sequence":"additional","affiliation":[{"name":"Epworth HealthCare Richmond Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Oxley","sequence":"additional","affiliation":[{"name":"Epworth HealthCare Richmond Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Brennan","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Centre of Cardiovascular Research and Education in Therapeutics Monash University Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Lefkovits","sequence":"additional","affiliation":[{"name":"Nursing and Health Sciences,\u00a0Faculty of Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Cardiology Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Duffy","sequence":"additional","affiliation":[{"name":"Nursing and Health Sciences,\u00a0Faculty of Medicine Monash University Melbourne Victoria Australia"},{"name":"Department of Cardiology The Alfred Hospital Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6289-583X","authenticated-orcid":false,"given":"Sarah","family":"Zaman","sequence":"additional","affiliation":[{"name":"School of Clinical Sciences at Monash Health Monash University Melbourne Victoria Australia"},{"name":"Westmead Applied Research Centre University of Sydney Sydney New South Wales Australia"},{"name":"Department of Cardiology Westmead Hospital Sydney New South Wales 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