男性和女性首次急性心肌梗死的类型和部位的预测因素。

Predictors of type and site of first acute myocardial infarction in men and women.

作者信息

Fabijanić Damir, Giunio Lovel, Culić Viktor, Bozić Ivo, Martinović Duska, Mirić Dinko

机构信息

Department of Internal Medicine, University Hospital Split, Soltanska 1, 21 000 Split, Croatia.

出版信息

Ann Saudi Med. 2005 Mar-Apr;25(2):134-9. doi: 10.5144/0256-4947.2005.134.

DOI:10.5144/0256-4947.2005.134

PMID:15977692

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6147975/

Abstract

BACKGROUND

The importance of pathophysiological mechanisms involved in onset of acute myocardial infarction (AMI) differs with age, gender, and risk profiles. Diversity in the triggering of cardiovascular events has been observed, particularly between men and women. Therefore, we investigated the relationship between age, gender, and risk factors and location of AMI and the presence of Q waves in ECG.

PATIENTS AND METHODS

Data was obtained from a chart review of 2958 patients with first AMI: 770 (26%) patients with non-Q-wave AMI and 2188 (74%) patients with Q-wave AMI. Four clinical groups were formed by predetermined criteria (anterior Q-wave, anterior non-Q-wave, inferior Q-wave, inferior non-Q-wave). A logistic regression was performed to assess independent predictors of AMI type and site.

RESULTS

Key findings were: 1) inferior non-Q-wave AMI was more frequent in young women (P<0.001); 2) inferior Q-wave AMI was more common in young men (P<0.001); 3) anterior non-Q-wave AMI was more common in older men (P<0.001). Multivariate analysis revealed that independent predictors of anterior non-Q-wave AMI were age over 65 (P=0.002), male gender (P=0.04) and hypercholesterolemia (P=0.0003), and that predictors of inferior Q-wave AMI were male gender (P<0.0001), smoking (P=0.04) and diabetes (P=0.049). In the gender-subgroup analyses, age <45 years (P=0.04), hypecholesterolemia (P=0.02) and smoking (P=0.01) were independent predictors of inferior Q-wave AMI whereas age >65 years (P<0.0001) and smoking (P=0.0003) were predictors of anterior non-Q-wave AMI in men. In women, age <45 years (P<0.0001) and smoking (P=0.02) were independent predictors of non-Q-wave AMI and hypercholesterolemia (P=0.02) was a predictor of inferior Q-wave AMI.

CONCLUSION

The link between particular types and the site of AMI and age, gender and risk factors suggest that the importance of pathophysiological mechanisms for onset of AMI differs according to sex and age subgroup.

摘要

背景

急性心肌梗死（AMI）发病过程中涉及的病理生理机制的重要性因年龄、性别和风险状况而异。已观察到心血管事件触发因素存在差异，尤其是男性和女性之间。因此，我们研究了年龄、性别、风险因素与AMI部位以及心电图中Q波存在情况之间的关系。

患者与方法

数据来自对2958例首次发生AMI患者的病历回顾：770例（26%）非Q波AMI患者和2188例（74%）Q波AMI患者。根据预定标准形成四个临床组（前壁Q波、前壁非Q波、下壁Q波、下壁非Q波）。进行逻辑回归分析以评估AMI类型和部位的独立预测因素。

结果

主要发现如下：1）年轻女性中下壁非Q波AMI更为常见（P<0.001）；2）年轻男性中下壁Q波AMI更为常见（P<0.001）；3）老年男性中前壁非Q波AMI更为常见（P<0.001）。多变量分析显示，前壁非Q波AMI的独立预测因素为65岁以上（P=0.002）、男性（P=0.04）和高胆固醇血症（P=0.0003），而下壁Q波AMI的预测因素为男性（P<0.0001）、吸烟（P=0.04）和糖尿病（P=0.049）。在性别亚组分析中，年龄<45岁（P=0.04）、高胆固醇血症（P=0.02）和吸烟（P=0.01）是下壁Q波AMI的独立预测因素，而年龄>65岁（P<0.0001）和吸烟（P=0.0003）是男性前壁非Q波AMI的预测因素。在女性中，年龄<45岁（P<0.0001）和吸烟（P=0.02）是非Q波AMI的独立预测因素，高胆固醇血症（P=0.02）是下壁Q波AMI的预测因素。