Department of Cardiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand; Department of Medicine, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India.
Department of Endocrinology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Ann Afr Med. 2022 Jan-Mar;21(1):8-15. doi: 10.4103/aam.aam_38_20.
Acute coronary syndrome (ACS) differs in women and men with respect to risk factors, clinical presentation, complications and outcome. The major reason for the differences has been the effect of estrogen which protects women from coronary artery disease (CAD) till menopause. Women develop CAD one decade later than men. Hence, we compared the profile of ACS in postmenopausal women with age-matched men to see, does the difference still exist.
Comparative prospective study of 50 postmenopausal women as study group and fifty age-matched men as a control group diagnosed with ACS, who were admitted in a medical college hospital from December 2013 to September 2015. Chi-square test and Student's t-test have been used to find the significant association of study parameters between women and men.
Chest pain was the main complaint in the majority of the women (76%) and men (88%). Radiation of chest pain (60%) and sweating (72%) were significantly present in men compared to women (24% and 26%, respectively), whereas breathlessness was significantly present in women (40%) compared to men (16%). Women had later presentation to the hospital after symptom onset compared to men. Women had a higher respiratory rate (22.02 cycles/min) compared to men (20 cycles/min) and more crepitations compared to men. Men had more ventricular tachycardia (14%) and intracerebral hemorrhage (4%), whereas women had all other complications more than or same as men and higher in-hospital mortality (14%) compared to men (8%).
Postmenopausal women with ACS had more atypical presentation of symptoms, later presentation to hospital, more tachypnea, more crepitations, more complications, and higher in-hospital mortality compared to men of the same age group. The difference in the profile of ACS continues to exist even after menopause and age matching.
急性冠状动脉综合征（ACS）在女性和男性中的危险因素、临床表现、并发症和结局存在差异。造成这些差异的主要原因是雌激素的作用，它可以保护女性免受冠状动脉疾病（CAD）的侵害，直到绝经。女性患 CAD 的时间比男性晚十年。因此，我们比较了绝经后女性和年龄匹配的男性 ACS 的发病情况，以了解这种差异是否仍然存在。
对 2013 年 12 月至 2015 年 9 月期间在一所医学院附属医院住院的 50 名绝经后女性（研究组）和 50 名年龄匹配的男性（对照组）进行了前瞻性比较研究。采用卡方检验和学生 t 检验比较两组女性和男性的研究参数的显著相关性。
胸痛是大多数女性（76%）和男性（88%）的主要主诉。胸痛放射（60%）和出汗（72%）在男性中明显多于女性（分别为 24%和 26%），而呼吸困难在女性中明显多于男性（40%对 16%）。女性从症状发作到就诊的时间比男性晚。女性的呼吸频率（22.02 次/分钟）高于男性（20 次/分钟），肺部啰音也多于男性。男性发生室性心动过速（14%）和脑出血（4%）的比例较高，而女性发生其他所有并发症的比例均高于或与男性相同，院内死亡率（14%）也高于男性（8%）。
绝经后 ACS 女性的症状表现更不典型，就诊时间更晚，呼吸急促、肺部啰音更多，并发症更多，院内死亡率也更高，与同年龄组男性相比。即使在绝经和年龄匹配后，ACS 患者的发病情况仍存在差异。
