Gender differences in the clinical presentation, treatment and outcomes of acute myocardial infarction

Abstract

Abstract. Aim: To assess the epidemiological and clinical differences between men and women with acute myocardial infarction (AMI). Patients and methods: This retrospective study included 579 patients (352 men and 221 women) who were hospitalized at the Coronary and postcoronary unit at the General Hospital, Karlovac, Croatia, from 2013 to 2016. We determined the frequency, patient's age, type of symptoms, cardiovascular risk the factors, localization, the time from the onset of symptoms to arrival to the hospital, treatment and complications during the hospitalization. Results: AMI is more frequent in men than in women (P < 0.001) and in men it is significantly more likely to occur at an earlier age than in women (P < 0.001). Men often have typical symptoms while women have atypical symptoms (P = 0.045). More often women have arterial hypertension (P = 0.017) and diabetes (P = 0.025), while men are more often smokers (P = 0.001). There was no difference between the gender regarding hyperlipidemia (P = 0,674). Distribution of localization (P = 0.608), the time required for the arrival to the hospital (P = 0.399) and all the complications of AMI are equal (P = 0.365). Men are more likely to receive PCI treatment, while women get the conservative therapy (P = 0.007). Conclusion: Compared with other studies, our women with AMI have less hyperlipidemia and do not come later to hospital than men. Possible causes are dietary habits and genetics or education and good organization of outpatient emergency medical assistance.Key words: acute myocardial infarction; cardiovascular risk; Croatia; hospital treatment Sažetak. Cilj: Ispitati epidemiološke i kliničke razlike između žena i muškaraca s akutnim infarktom miokarda (AIM). Bolesnici i metode: Ova retrospektivna studija obuhvatila je 579 pacijenata (352 muškarca i 221 ženu) hospitaliziranih u koronarnoj i postkoronarnoj jedinici Opće bolnice Karlovac, Hrvatska, od 2013. do 2016. godine. Utvrdili smo učestalost, dob pacijenata, tip simptoma, kardiovaskularne rizične čimbenike, lokalizaciju, vrijeme od početka simptoma do dolaska u bolnicu, liječenje i komplikacije tijekom hospitalizacije AIM-a. Rezultati: AIM je češći kod muškaraca nego kod žena (P < 0,001) i kod muškaraca je značajno vjerojatnije da će se pojaviti u ranijoj dobi nego kod žena (P < 0,001). Muškarci češće imaju tipične simptome, a žene atipične simptome (P = 0,045). Žene imaju češće arterijsku hipertenziju (P = 0,017) i dijabetes (P = 0,025), dok su muškarci češće pušači (P = 0,001). Hiperlipidemija je podjednako zastupljena u oba spola (P = 0,674). Distribucija lokalizacije (P = 0,608), vrijeme potrebno za dolazak u bolnicu (P = 0,399) i sve komplikacije AIM-a podjednako su česti (P = 0,365). Muškarci se češće liječe invazivnom, a žene konzervativnom terapijom. Zaključak: U usporedbi s drugim istraživanjima naše žene s AIM-om imaju manju učestalost hiperlipidemije i ne dolaze kasnije u bolnicu od muškaraca. Mogući razlozi su prehrambene navike i genetika ili obrazovanje i dobra organizacija izvanbolničk...