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Objective To analyze in-hospital mortality for female patients with ST-segment elevation myocardial infarction (STEMI).Methods 1189 patients were enrolled.At first, 320 female patients were compared with 869 male patients about baseline (i.e.age,comorbidity, etc) and clinical factors (i.e.typical angina pectoris, in-hospital mortality, etc).Then analyze gender defferences of in-hospital mortality in a multivariate model.Results Compared with male patients, female patients were older(68.51 years vs.60.76 years, P<0.001), the morbidities of type 2 diabetes mellitus and hypertensionwere significant higher in female patients than in male patients (24.4% vs.14.6%, P<0.001; 61.3% vs.42.2%, P<0.001, respectively), the rates of mental labors,smokers, drinkers were significant lower in female patients than in male patients(3.4% vs.23.7%, P<0.001; 27.2% vs.68.1%, P<0.001 ; 2.2% vs.27.0%, P<0.001;respectively); Female patients were presented with less triggering factors and typical symptoms but more complications than male patients (27.5% vs.35.9%, P=0.008; 50.9% vs.68.2%, P<0.001; 41.9% vs.32.2%, P=0.002, respectively), fewer female patients accepted actue reperfusion therapy than male patients (67.2% vs.77.7%, P<0.001).In-hospital mortality in female patients were significant higher than in male patients (17.5% vs.7.9%, P<0.001) , multivariate analysis revealed that female gender was not an independent predictor of in-hospital mortality (P=0.109) ,while age,hypertension and acute reperfusion therapy were independent predictors of in-hospital mortality(P < 0.001, P=0.022, P < 0.001, respectively).Conclusion In-hospital mortality in female patients with STEMI were significant higher than in male patients.This is because of the gender difference of age, hypertension and acute reperfusion therapy, female gender was not an independent predictor of in-hospital mortality in patients with STEMI.