Particularities of non-ST-elevation myocardial infarction in women

Abstract

Despite the fact that women have lower incidence of non-ST-elevation myocardial infarction (NSTEMI) compared with men, they have a higher mortality, attributed to the impact of the age, higher burden of comorbidities, atypical symptoms and possible differences in the diagnosis and treatment of NSTEMI. Based on this, we aimed to evaluate the sex differences in the clinical presentation, management and major adverse cardiovascular events (MACE) of patients presenting with NSTEMI in the Republic of Moldova. Data were collected from the observational studies: retrospective (2019) and prospective (2020-2021), conducted in 3 PCI centers in Moldova, which included 351 consecutive patients with the clinical diagnosis NSTEMI. The data obtained were processed by descriptive statistical methods, using the t-test, the Pearson χ² test and the p-value. After analyzing the obtained results, we concluded that women had a lower incidence of NSTEMI, but had a higher rate of risk factors and comorbidities, compared to men, they presented more frequently atypical symptoms and more often had myocardial infarction with non-obstructive coronary arteries (MINOCA). At the same time, several gaps in the management of women with NSTEMI in the Republic of Moldova were highlighted. MACE proved to be similar at both sexes, but with a higher mortality at women. These data guide us to the need of a comprehensive approach of women with NSTEMI, taking into account the gender particularities in the clinical presentation and management of the disease.