Fibrinolytic therapy in young women with acute myocardial infarction.

STUDY OBJECTIVE

Previous studies found that women with acute myocardial infarction (AMI) receive less aggressive therapy compared with men. We sought to determine the percentage of young women (</=50 years) with an AMI eligible for fibrinolytic therapy who received it and explore factors resulting in the ineligibility of women for fibrinolytic therapy.

METHODS

A retrospective chart review was conducted for women 50 years of age or younger who were discharged from a tertiary cardiac care hospital with a diagnosis of AMI during the period 1990 to 1995. Women were included if they met the World Health Organization criteria for AMI.

RESULTS

There were 126 women meeting inclusion criteria with 54 (43%) receiving fibrinolytic therapy. Sufficient information to determine eligibility for fibrinolytic therapy was available for 118 (94%) of the women. Forty-one (91%) of the 45 women who met eligibility criteria received fibrinolytic therapy. Of the 73 women who were ineligible for fibrinolytic therapy, 52 (71%) had a nondiagnostic ECG, 28 (38%) presented 12 hours after symptom onset, and 19 (26%) had an absolute or relative contraindication to fibrinolytic therapy. Of the women not meeting eligibility requirements, 15% nonetheless received fibrinolytic therapy.

CONCLUSION

In this study, most young women with AMI who were eligible for fibrinolytic therapy received it. Nondiagnostic ECG and late presentation to the emergency department (>12 hours after symptom onset) were the most common reasons for ineligibility.