Abstract
Objective: investigation of gender features and their role in progression and treatment of acute myocardial infarction (MI). Materials and methods. 244 patients aged 30–85 (mean age 61.2 ± 12.3) with MI were included in this study. They were divided into 2 groups depending on their gender: the 1st group was comprised of 80 (32.8 %) women, the 2nd group – of 164 (67.2 %) men. We evaluated patients’ demographic data, diagnosis and its complications, comorbidities, medical history and risk factors (RF) of coronary heart disease (CHD), in-patient therapeutic activities, in-hospital mortality rate, and 12-month mortality rate after MI. Results. In women MI was significantly more often associated with arterial hypertension (p 0,05), however severe (class III–IV) heart failure was more common in female population (31.2 % vs 23.7 %; RR 1.31; 95 % CI 0.85–2.01; p > 0.05).Mortality rate was higher in women than in men (27.5 % vs 15.2 %; RR 1.8; 95 % CI 1.08–2.99; р 0.05). During the first 6 months after MI we found a tendency of higher mortality rate in females than in males (6.2 % vs 1.8 %; RR 3.41; 95 % CI 0.83–13.9; p > 0.05), but after 6–12 months after discharge males tended to have higher mortality than females (4.3 % vs 2.5 %; RR 0.58; 95 % CI 0.12–2.75; p > 0.05). Conclusion. The most important risk factors for MI in females are diabetes mellitus, arterial hypertension and obesity. MI in women is associated with severe HF development; their immediate prognosis and disease outcome is usually less favorable, than in men.
Highlights
Цель исследования – изучение гендерных особенностей течения и лечения острого инфаркта миокарда (ИМ)
We evaluated patients’ demographic data, diagnosis and its complications, comorbidities, medical history and risk factors (RF) of coronary heart disease (CHD), in-patient therapeutic activities, in-hospital mortality rate, and 12-month mortality rate after myocardial infarction (MI)
During the first 6 months after MI we found a tendency of higher mortality rate in females than in males (6.2 % vs 1.8 %; RR 3.41; 95 % confidence interval (CI) 0.83–13.9; p > 0.05), but after 6–12 months after discharge males tended to have higher mortality than females (4.3 % vs 2.5 %; RR 0.58; 95 % CI 0.12–2.75; p > 0.05)
Summary
Частота летальных исходов была статистически значимо выше у женщин (27,5 % против 15,2 %; ОР 1,8; 95 % ДИ 1,08–2,99; р < 0,05), у них чаще регистрировалась как госпитальная (18,7 % против 9,1 %; ОР 2,05; 95 % ДИ 1,05–3,98; р < 0,05), так и постгоспитальная смертность (8,7 % против 6,1 %; ОР 1,43; 95 % ДИ 0,56–3,63; р > 0,05). В течение первых 6 мес после ИМ тенденция к большей частоте летальных исходов прослеживалась у женщин (6,2 % против 1,8 %; ОР 3,41; 95 % ДИ 0,83–13,9; p > 0,05), а у мужчин она была выше спустя 6–12 мес после выписки из стационара (4,3 % против 2,5 %; ОР 0,58; 95 % ДИ 0,12–2,75; p > 0,05). Ключевые слова: инфаркт миокарда, коронарная болезнь сердца, сердечная недостаточность, факторы риска, артериальная гипертензия, сахарный диабет, ожирение, гендерные особенности, летальность, реваскуляризация миокарда, коронароангиография, чрескожное коронарное вмешательство
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