Особенности неблагоприятного течения и летальность при остром инфаркте миокарда у женщин и мужчин

Abstract

The cause of mortality in the Russian Federation in half of cases is still cardiovascular diseases (CVD), the most prognostically unfavorable variant of which is certainly acute myocardial infarction (AMI). At the same time, there is a steady tendency to increase the frequency of myocardial infarction in women of working age. The frequency and severity of AMI in women is underestimated by many researchers, and the prognostic factors of an unfavorable outcome in comparison of female and male individuals are not determined. Objective. The aim of the study was to compare the immediate prognosis and outcome of AMI in women and men, and to identify possible factors leading to an unfavorable outcome. Materials and methods. The analysis of medical cases and pathoanatomical reports of 196 patients who died from AMI within a 5-year period, among whom there were 107 women (average age 72.1±7.2 years) and 89 men (average age 65.4±11.1 years). The authors compared the case, clinical features of the disease, complications, the presence of comorbidities, the depth and localization of AMI, and the direct causes of deaths. Results. In groups comparable in age, the mortality rate in women over 60 years was 1.6 times higher than that in men. Somewhat more often, women died in this case, whose MI began with a typical pain syndrome or an asthmatic variant of it. Concomitant pathology in women who died from MI was significantly more common than in men: arterial hypertension, diabetes mellitus (1.5 times) and obesity (6.5 times). The unfavorable prognostic factors in MI in men can be the previous stroke. Conclusion. The immediate prognosis of mortality in AMI in women is more unfavorable than in men. The immediate causes of death in women compared to men were more often cardiogenic shock, myocardial ruptures and pulmonary embolism, and in men - acute cardiovascular failure and ventricular fibrillation.