Women have a poorer prognosis following ST-elevation MI (STEMI) than men.1–7 Although sex-based differences in post-STEMI outcome are well documented, the reasons for these poorer outcomes in women are less well defined, which limits our ability to close this sex-based outcome gap. The role played by differences in the anatomical complexity of coronary artery disease or by multivessel disease (MVD) in sex-based outcome differences at long-term follow-up is not well established.