Gender-related features of reperfusion therapy in patients with ST segment elevation myocardial infarction
Abstract
Aim. To investigate the gender differences in reperfusion therapy use among patients with ST segment elevation myocardial infarction (STEMI). Material and methods. The in-hospital therapy was assessed in 343 men and 186 women with STEMI. Results. There were significant differences in reperfusion rates among male and female patients. In total, reperfusion was performed in 265 men (77,2%) and 105 women (56,4%; р<0,05). Over 50% of the male patients underwent percutaneous coronary intervention (55,6%), in contrast with 39,2% of the female patients (р<0,05). The reason for this difference could be not gender per se, but co-existing diabetes mellitus, late diagnostics of acute coronary syndrome (ACS), and older age (over 70 years), which were more prevalent in women. Conclusion. Women with ACS are in need for more effective diagnostics and treatment.
About the Authors
O. L. BarbarashRussian Federation
O. A. Vasilyeva
Russian Federation
E. V. Tavlueva
Russian Federation
M. V. Zykov
Russian Federation
G. V. Moiseenkov
Russian Federation
L. S. Barbarash
Russian Federation
References
1. Оганов Р.Г., Шальнова С.А., Калинина А.М и др. Новый способ оценки индивидуального сердечно-сосудистого риска для населения России. Кардиология 2008; 5: 87-92.
2. Wenger NK, Collins P. Women’s and heart disease. Taylor and francis 2005; 640.
3. Lerner DJ, Kannel WB. Patterns of coronary heart disease morbidity and mortality in the sexes: a 26 — year follow — up of the Framingham population. Am Heart J 1986; 111: 383-90.
4. Raine R, Goldfrad C, Rowan K, Black N. Influence of patient gender on admission to intensive care. J Epidemiol Community Health 2002; 56 (6): 418-23.
5. Vittinogh E, Shlipak MG, Varosy PD, et al. for the Heart and Estrogen/progestin Replacement Study Research Group. Risk factors and secondary prevention in women with heart disease: the Heart and Estrogen/progestin Replacement Study. Ann Intern Med 2003; 138: 81-9.
6. Di Cecco R, Patel U, Upshur RE. Is there a clinically significant gender bias in post-myocardial infarction pharmacological management in the older (>60) population of a primary care practice? BMC Fam Pract 2002; 3 (1): 8.
7. Trappolini M, Chillotti FM, Rinaldi R, et al. Sex differences in incidence of mortality after acute myocardial infarction. Ital Heart J 2002; 3(7): 759-66.
8. Moriel M, Feld S, Almagor Y, et al. Results of coronary artery stenting in women versus men: a single center experience. Isr Med Assoc J 2003; 5(6): 398-402.
9. Ottesen MM, Kober L, Jorgensen S. Determinants of delay between symptoms and hospital admission in 5978 patients with acute myocardial infarction. Eur Heart J 1996; 17: 429-37.
10. O’Farrel P, Murray J, Huston P. Sex differences in cardiac rehabilitation. Can J Cardiol 2000; 16 (3): 319-25.
11. Grines CL, Serruys P, O’Neill WW. Fibrinolytic therapy: is it a treatment of the past? Circulation 2003; 107: 2538-42.
12. Steg FG, Ross AM. Increased all-cause mortality at 2-year follow-up after PCI with drug-eluting stents versus bare-metal stents in acute coronary syndrome: the GRACE Registry JACC 2008; http://www.medscape.com/viewarticle/570169.
13. Ghali WA, Faris PD, Galbraith PD, et al. Sex differences in access to coronary revascularization after cardiac catheterization: importance of detailed clinical data. Ann Intern Med 2002; 136: 723-32.
14. Аронов Д.М. Постстационарная реабилитация больных основными сердечно-сосудистыми заболеваниями на стационарном этапе. Кардиология 1998; 8: 69-77.
15. Woodward M, Barzi F, Huxley R. Woman have a greater excess relative risk for coronary death associated with diabetes than men. Second International Conference on Women, Heart Disease, and Stroke. February 16-19, 2005, Oriando, FL. Abctract 155.
16. Глезер М.Г. Антигипертензивная терапия и сахарный диабет. Пробл жен здор 2007; 2(2): 44-57.
17. Anderson HV, Shaw RE, Brindis RG, et al. A contemporary overview of percutaneous coronary interventions. The American College of Cardiology-National Cardiovascular Data Registry. JACC 2002; 39: 1096-103.
18. Эрлих А.Д., Грацианский Н.А. Регистр острых коронарных синдромов РЕКОРД. Характеристика больных и лечение до выписки из стационара. Кардиология 2009; 7-8: 4-12.
19. Lansky AJ, Hochman JS, Ward PA, et al. Percutaneous coronary intervention and adjunctive pharmacotherapy in women. A statement for health care professionals from the American Heart Association. Circulation 2005; 111: 940-53.
20. Mehilli J, Kastrati A, Dirschinger J, et al. Defferences in prognostic factors and outcomes between women and men undergoing contemporary percutaneous coronary intervention. JAMA 2000; 284: 1799-805.
21. Canto JC, Allison JJ, Kiefe CL, et al. Relation of race and sex to the use of reperfusion therapy in Medicare beneficiaries with acute myocardial infarction. N Engl J Med 2000; 342: 1094-100.
22. Барбараш О.Л., Якушева Е.Ю., Тавлуева Е.В. и др. Факторы, определяющие прогноз у женщин с ишемической болезнью сердца. Пробл жен здор 2007; 2(2): 57-64.
23. Сайгитов Р.Т., Глезер М.Г. Определение активности креатинфосфокиназы у больных, госпиталзированных с острым коронарным синдромом: анахронизм или важный прогностический маркер? Пробл жен здор 2008; 3(3): 5-12.
24. Lansky AJ, Hochman JS, Ward PA, et al. Percutaneous coronary intervention and adjunctive pharmacotherapy in women. A statement for health care professionals from the American Heart Association. Circulation 2005; 111: 940-53.
25. Eysmann SB, Douglas PS. Reperfusion and revascularization strategies for coronary artery disease in women. JAMA 1992; 268: 1903-7.
26. Stone GW, Grines CL, Browne KF, et al. Comparison of in-hospital outcome in men versus women treated by either thrombolytic therapy or primary coronary angioplasty for acute myocardial infarction. Am J Cardiol 1995; 75: 987-92.
27. Hanratty B, Lawlor DA, Robinson MB, et al. Sex differences in risk factors, treatment and mortality after acute myocardial infarction: an observational study. J Epidemiol Community Health 2000; 54: 912-6.
Review
For citations:
Barbarash O.L., Vasilyeva O.A., Tavlueva E.V., Zykov M.V., Moiseenkov G.V., Barbarash L.S. Gender-related features of reperfusion therapy in patients with ST segment elevation myocardial infarction. Cardiovascular Therapy and Prevention. 2010;9(8):12-16. (In Russ.)