Svensson L, Nordlander R, Axelsson C, Herlitz J
Division of Cardiology, South Hospital, Stockholm, Sweden.
Int J Cardiol. 2006 May 10;109(2):241-7. doi: 10.1016/j.ijcard.2005.06.020. Epub 2005 Jul 21.
To describe predictors of myocardial infarction prior to hospital admission in women and men among patients with a suspected acute coronary syndrome without ST-elevation.
Prospective observational study in Stockholm and Göteborg, Sweden.
Of 433 patients who did fulfill the inclusion criteria 45% were women. Fewer women (17%) than men (26%) developed acute myocardial infarction (AMI) (p=0.054), particularly among patients with initial ST-depression, in whom AMI was developed in 22% of women and 54% of men (p = 0.001). Predictors for infarct development in women were: a history of AMI and advanced age. Among men they were: initial ST-depression or a Q-wave on ECG and elevation of biochemical markers (both recorded on admission of the ambulance crew). There was a significant interaction between gender and the influence of ST-depression on the risk for development of myocardial infarction (p < 0.05).
Among patients transported with ambulance due to a suspected acute coronary syndrome and no ST-elevation fewer women than men seem to develop AMI particularly among patients with ST-depression. These results suggest that early prediction of myocardial infarction might differ between women and men with acute chest pain.
描述疑似急性冠状动脉综合征且无ST段抬高的患者中，女性和男性入院前心肌梗死的预测因素。
在瑞典斯德哥尔摩和哥德堡进行的前瞻性观察性研究。
在433例符合纳入标准的患者中，45%为女性。发生急性心肌梗死（AMI）的女性（17%）少于男性（26%）（p=0.054），尤其是在初始ST段压低的患者中，22%的女性和54%的男性发生了AMI（p = 0.001）。女性发生梗死的预测因素为：AMI病史和高龄。男性的预测因素为：初始ST段压低或心电图上出现Q波以及生化标志物升高（均在救护人员入院时记录）。性别与ST段压低对心肌梗死发生风险的影响之间存在显著交互作用（p < 0.05）。
在因疑似急性冠状动脉综合征且无ST段抬高而用救护车转运的患者中，发生AMI的女性似乎少于男性，尤其是在ST段压低的患者中。这些结果表明，急性胸痛的女性和男性对心肌梗死的早期预测可能有所不同。
