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首次急性心肌梗死的男性和女性的短期死亡率是否存在差异?

[Does the short-term mortality differ between men and women with first acute myocardial infarction?].

作者信息

Aslan Belgin Unal, Karcioğlu Ozgür, Aslan Ozgür, Ayrik Cüneyt, Kulaç Esin, Güneri Sema

机构信息

Department of Public Health, Medical Faculty, Dokuz Eylül University, Izmir, Turkey.

出版信息

Anadolu Kardiyol Derg. 2002 Dec;2(4):284-90.

Abstract

OBJECTIVE

Women with myocardial infarction (MI) have been reported to have worse short-term prognosis than men. We aimed to compare men and women with first MI regarding 28 days survival, cardiovascular (CV) risk factors, clinical findings, and the treatment in the emergency setting.

METHODS

One-hundred and seventy-five consecutive patients with first MI admitted to the emergency department of our hospital within one year were included in the study. Data on admission time, CV risk factors, clinical findings and treatment options were obtained from the patient charts. Twenty-eight days after the first admission, patients were called by phone and asked information about their health status. Survival curves for men and women were compared using log rank test.

RESULTS

After the exclusion of 20 cases who were lost during the follow up, 117 men and 38 women were evaluated in the study; 9.4% of the men and 10.5% of the women died within 28 days (p=0.85). Women were older (10 years), had higher prevalence of hypertension (p=0.04), diabetes (p=0.01) and stroke history (p=0.02) than men. Men had higher levels of smoking history than women (79.1%, 31.6%; p<0.001). There were no significant gender differences regarding clinical findings, time to hospital admission after chest pain onset and time to thrombolysis. Thrombolysis was applied in 35.8% of women and in 48.6% of men patients. Primary PTCA was performed in 26.4% of men and 11.4% of women patients (p=0.16).

CONCLUSION

Women tended to be older and had more co-morbidities, but did not differ from men regarding clinical findings, treatment given in emergency department and short-term survival.

摘要

目的

据报道,心肌梗死(MI)女性患者的短期预后比男性更差。我们旨在比较首次发生MI的男性和女性在28天生存率、心血管(CV)危险因素、临床症状以及急诊治疗方面的情况。

方法

本研究纳入了我院急诊科在一年内连续收治的175例首次发生MI的患者。从患者病历中获取入院时间、CV危险因素、临床症状和治疗选择等数据。首次入院28天后,通过电话联系患者,询问其健康状况。使用对数秩检验比较男性和女性的生存曲线。

结果

排除随访期间失访的20例患者后,本研究共评估了117例男性和38例女性;9.4%的男性和10.5%的女性在28天内死亡(p = 0.85)。女性年龄更大(大10岁),高血压(p = 0.04)、糖尿病(p = 0.01)和中风病史(p = 0.02)的患病率高于男性。男性吸烟史水平高于女性(79.1%,31.6%;p < 0.001)。在临床症状、胸痛发作后入院时间和溶栓时间方面,性别差异无统计学意义。35.8%的女性患者和48.6%的男性患者接受了溶栓治疗。26.4%的男性患者和11.4%的女性患者进行了直接经皮冠状动脉腔内血管成形术(PTCA)(p = 0.16)。

结论

女性往往年龄更大且合并症更多,但在临床症状、急诊科给予的治疗和短期生存方面与男性并无差异。

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