Acute myocardial infarction: gender specifics of development and clinical course in an urban Western Siberian population
https://doi.org/10.15829/1728-8800-2012-3-12-15
Abstract
Aim. To study the gender specifics of acute myocardial infarction (AMI) among the adult population (age >20 years) of Tomsk City.
Material and methods. In total, 1628 AMI cases from the AMI Register (2007-2008) were analysed. The study included 992 (60,82%) men and 636 (39,18%) women.
Results. Compared to male patients, AMI in women typically developed in older age (over 60 years), was preceded by various forms of progressing angina pectoris, and associated with severe co-morbidities and pre-existing disease. Its clinical course was characterised by a high risk of recurrent MI, various complications, and in-hospital death. The leading causes of in-hospital death in women with AMI included cardiogenic shock, congestive heart failure, and myocardial rupture, in contrast to cardiac arrhythmias and cardiac blocks in their male peers.
Conclusion. The observed specifics of AMI development and clinical course in women could be both a barrier for a wider use of modern invasive treatment methods and an explanation of adverse prognosis. The AMI management guidelines should take into account gender-specific characteristics of the disease.
About the Authors
A. A. Garganeeva
Research Institute of Cardiology, Siberian Branch, Russian Academy of Medical Sciences, Tomsk
Russian Federation
Russian Federation
S. A. Okrugin
Research Institute of Cardiology, Siberian Branch, Russian Academy of Medical Sciences, Tomsk
Russian Federation
Russian Federation
Yu. I. Zyablov
Research Institute of Cardiology, Siberian Branch, Russian Academy of Medical Sciences, Tomsk
Russian Federation
Russian Federation
D. A. Parshin
Research Institute of Cardiology, Siberian Branch, Russian Academy of Medical Sciences, Tomsk
Russian Federation
Russian Federation
References
1. Novikova N.A., Gendlin G.E., Storozhakov G.I. Gender differences in patients with acute myocardial infarction. Heart Failure 2008; 3:137–43. Russian (Новикова Н.А., Гендлин Г.Е., Сторожаков Г.И. Гендерные различия у больных с острым инфарктом миокарда. Сердечная недостаточность 2008; 3: 137–43).
2. Gurevich M.A., Mravyan S.R., Grigorieva N.M. Coronary heart disease in women. The difficult patient 2006; 12:1-13. Russian (Гуревич М.А., Мравян С.Р., Григорьева Н.М. Ишемическая болезнь сердца у женщин. Трудный пациент 2006; 12: 1–13).
3. Oganov R.G. Mortality from cardiovascular diseases in Russia and some of the factors influencing it. Cardiology 1994; 4, 80–3. Russian (Оганов Р.Г. Смертность от сердечно сосудистых заболеваний в России и некоторые влияющие на нее факторы. Кардиология 1994; 4: 80–3).
4. Karpov R.S., Mordovin V.F. Diagnosis and treatment of coronary heart disease in women. Tomsk 2002; 196 p. Russian (Карпов Р.С., Мордовин В.Ф. Диагностика и лечение ишемической болезни сердца у женщин. Томск 2002: 196 c).
5. Anderson G.D. Sex and racial differences in pharmacological response. Where is the evidence? Pharmacogenetics, pharmacokinetics and pharmacodynamics. J. Womens Health 2005; 14: 19–29.
6. Betig Z., Mazur N.A., Metelitsa V.I. Comparative data on the registers of myocardial infarction in Moscow and Berlin. In epidemiology of cardiovascular disease. Moscow: Medicine 1977; pp. 166-93. Russian (Бетиг З., Мазур Н.А., Метелица В.И. Сравнительные данные по регистрам инфаркта миокарда в Москве и Берлине. В кн. Эпидемиология сердечно сосудистых заболеваний. М.: Медицина 1977; 166–93).
7. Marrugat J., Sala J., Masia R., et al. Mortality differences between men and women following first myocardial infarction. JAMA 1998; 280: 1405–9.
8. Tsigankova, O.V., Fedorova E.L., Bondareva Z.G. and al. Сoronary heart disease in women. Features of the risk factors and clinical course of myocardial infarction according to age. Heart 2010; 1: 26–32. Russian (Цыганкова О.В., Федорова Е.Л., Бондарева З.Г. и др. Ишемическая болезнь сердца у женщин. Особенности факторов риска и клинического течения инфаркта миокарда в зависимости от возраста. Сердце 2010; 1: 26–32).
9. Mosca L. Epidemiology and prevention of heart disease. In: Douglas P.S. ed. Cardiovascular Health and Disease in Women. 2nd end. New York: WB Saunders; 2002: 23–8.
10. Mokdad A.H., Ford E.S., Bowman B.A., et al. Prevalence of obesity, diabetes, and obesity-related health risk factors. JAMA 2003; 289: 76–9.
11. Boytsov S.A., Deryugin M.V., Turdialieva S.A. and al. The course of acute myocardial infarction depending on the length of hospitalization. Ambulance 2000; 2: 23–7. Russian (Бойцов С.А., Дерюгин М.В., Турдиалиева С.А. и др. Особенности течения острого инфаркта миокарда в зависимости от сроков госпитализации. Скорая медицинская помощь 2000; 2: 23-7).
12. Glezer G.A., Glaser M.G. Hypertension. Moscow 1996: 216 p. Russian (Глезер Г.А., Глезер М.Г. Артериальная гипертония. Москва 1996: 216 с).
13. All-Russian Scientific Society of Cardiology. Recommendations for treatment of acute coronary syndromes without persistent ST-segment elevation on ECG. Cardiology 2004; 44 (4): Application. Russian (Всероссийское научное общество кардиологов. Рекомендации по лечению острого коронарного синдрома без стойкого подъема сегмента ST на ЭКГ. Кардиология 2004; 44 (4): Приложение).
14. Diagnostics and the treatment of patients with acute myocardial infarction with ST-segment elevation electrocardiogram. Russian recommendations. Cardiovascular Therapy and Prevention 2007; 6 (8). Application. Russian (Диагностика и лечение больных острым инфарктом миокарда с подъемом сегмента ST электрокардиограммы. Российские рекомендации. Кардиоваскулярная терапия и профилактика 2007; 6(8): Приложение).
Review
For citations:
Garganeeva A.A., Okrugin S.A., Zyablov Yu.I., Parshin D.A. Acute myocardial infarction: gender specifics of development and clinical course in an urban Western Siberian population. Cardiovascular Therapy and Prevention. 2012;11(3):12-15. (In Russ.) https://doi.org/10.15829/1728-8800-2012-3-12-15
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