Gutierrez P S, Higuchi M de L, de Moraes C F, Gallucci S D, Lopes E A, da Silva M J, Ramires J A, Bellotti G
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo.
Arq Bras Cardiol. 1990 Mar;54(3):189-92.
To compare morphological characteristics from myocardial infarction (IM) in men and women in 200 consecutive necropsies.
Necropsy heart findings from 62 female cases compared with those from 138 male cases, from patients who died from transmural myocardial infarction. Age ranged from 21 to 82 (mean 60) years.
Concerning the coronary arteries, the number of 3 major (right, left anterior descending and left circumflex) epicardial coronary arteries narrowed at some point greater than 70% in cross-sectional area by atherosclerotic plaque was not significantly different; on the other hand, there were more severe lesions in the left main coronary artery in men (10.33%) than in women (1.64%) (p = 0.050). 33.33% of men and 43.55% of women had only recent myocardial infarction (1 month or less); 33.33% of men and 14.52% of women had only old myocardial infarction (more than 1 month); 33.33% of men and 41.94% of women had both recent and old myocardial infarction. 12.90% of women and 2.17% of men showed rupture of the left ventricle (p = 0.0220). 15.22% of men and 6.45% of women had left ventricular aneurysms (p = 0.830).
There are more deaths during the acute phase of MI, in the first infarction and from rupture of the left ventricle in female patients; in men, there are more deaths occurring in chronic phases of the disease and with previous myocardial infarction; and more severe narrowing from the left main coronary artery.
在连续200例尸检中比较男性和女性心肌梗死（MI）的形态学特征。
对62例女性和138例男性因透壁性心肌梗死死亡患者的尸检心脏结果进行比较。年龄范围为21至82岁（平均60岁）。
关于冠状动脉，3支主要的心外膜冠状动脉（右冠状动脉、左前降支和左旋支）中，因动脉粥样硬化斑块导致横截面积在某一时刻狭窄大于70%的数量在男性和女性中无显著差异；另一方面，男性左主冠状动脉的病变比女性更严重（男性为10.33%，女性为1.64%）（p = 0.050）。33.33%的男性和43.55%的女性仅有近期心肌梗死（1个月或更短时间）；33.33%的男性和14.52%的女性仅有陈旧性心肌梗死（超过1个月）；33.33%的男性和41.94%的女性既有近期心肌梗死又有陈旧性心肌梗死。12.90%的女性和2.17%的男性出现左心室破裂（p = 0.0220）。15.22%的男性和6.45%的女性有左心室室壁瘤（p = 0.830）。
女性患者在心肌梗死急性期、首次梗死和左心室破裂时死亡更多；男性在疾病慢性期和有既往心肌梗死时死亡更多；且左主冠状动脉狭窄更严重。
