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BackgroundHeart conditions are a leading cause of mortality and morbidity worldwide.The burden associated with different heart diseases such as ST-Segment Elevation Myocardial Infarction（STEMI）is directly related to risk factors,inflammatory cascades,poor prognosis and mortality especially when diagnosis is prolonged without appropriate intervention.China has seen a rise in STEMI patients in the past decade.It is understood that female STEMI patients tend to have worse outcomes when compared to male STEMI patients in the first world countries.It is yet to be clarified if middle income countries or countries on the verge to become first world countries such as China have similar consequence of STEMI in female patients.Aim and ObjectiveOur objective was to compare the in-hospital outcomes between male and female STEMI patients.All the analyzed variables were used to compare male and female STEMI patients discharged between 2017 to 2019 in a retrospective analysis of retrieved data from the Affiliated hospital of Jiangsu University Zhenjiang,Jiangsu,PRC.MethodsThe patients who were discharged from the Department of Cardiology,Affiliated Hospital of Jiangsu University from July 2017 to December 2019 were retrospectively analyzed.The patients who were mainly diagnosed as acute ST segment elevation myocardial infarction were enrolled.We compared the clinical characterize of the female and male STEMI patients,analyzed of acute management and medical therapies for secondary prevention between female and male STEMI patients.We evaluated sex differences in medical treatment,and in-hospitalmajor adverse cardiac events（MACE）in STEMI patients.ResultsIn this retrospective analysis,472 STEMI patients were evaluated.There were117 females and 355 male.Female and male patients had equivalent mean ages of63.9 ± 9.4 and 62.9 ± 10.1 years,respectively.Males and females have a similar proportion of hypertension（66.7 % vs 62.5 %,P > 0.05）.Smoking,drinking and hyperlipidemiapercentage is bigger in male,while female have bigger higher prevalence of diabetes than male patients（31.6 % vs 20.8 %,P < 0.05）.Other history includes angina,myocardial infarction,heart failure,stroke and TIA seems no difference between groups（P>0.05）.The values of laboratory indexes were measured and compared in all patients.Despite the fact that this study showed no significance difference in terms of the laboratory indexes between male and female,the variables showed different magnitude in mean values among the two study groups.The level of the Troponin I was higher in male patients（11.65± 8.641）compared to the female patients（13.61 ±15.596,P>0.05）.CK-MB,were found higher in male patients compared with female patients whereas,female patients were seen high in BNP,LDL,TG,Hb A1 C in comparison male patients,although there was no significant difference between the two groups.In acute management,the vast majority of patients in the acute phase have received standardized drug treatment according to the guidelines.99.1% of women and 99.7% of men were given dual antiplatelet therapy on admission,and more than90% of STEMI patients were given β-block and Statins.The use of ACEI/ARB is slightly lower（female 87.2% vs male 84.8%,P > 0.05）.Female have much lower reperfusion rate and anticoagulant use rate during hospitalization than male,（81.2% vs 95.5%,93.2% vs 99.2%,respectively,P<0.05）.In medical therapies for secondary prevention,patients were less likely to receive DAPT（95.8%vs.99.6%）,statins（91.1% vs.99.7%）,β-blockers（85.2% vs.92.4%）and ACEIs/ARBs（80.1% vs.85.4%）at discharge compared to acute treatment,but have no significant difference between male and female.The result showed that the in-hospital MACEs rate was higher in women than in men（35.8% vs.33.0%,P=0.035）.Afteradjustment for clinical characteristics and the acute treatment,the sex difference in in-hospital MACEs was eliminated（adjusted OR,0.784（0.270-2.273）,P=0.654）.ConclusionsFemale STEMI patients showed a higher unadjusted risk of in-hospital MACEs than males.The sex difference was eliminated after adjustment for clinical characteristics and acute treatments.Females were less likely to receive reperfusion therapy than males.It may be the main cause.