Karlson B W, Herlitz J, Hartford M, Hjalmarson A
Division of Cardiology, Sahlgrenska Hospital, Göteborg, Sweden.
Coron Artery Dis. 1993 Sep;4(9):761-7. doi: 10.1097/00019501-199309000-00002.
Previous studies suggest a gender-related difference in prognosis among patients with ischaemic heart disease. In the present study, we aimed to describe the characteristics and prognosis among patients with suspected ischaemic heart disease in relation to gender.
During the 21 months of the study, all patients who came to the medical emergency room of one single hospital as a result of chest pain or other symptoms suggestive of acute myocardial infarction were prospectively followed for 1 year.
A total of 5362 patients were admitted on 7157 occasions; men accounted for 55% of the admissions. The 1-year mortality rate was 11% for men compared with 10% for women. The women were older and had a higher prevalence of known congestive heart failure and hypertension, whereas the prevalence of previous myocardial infarction was higher in men. When correcting for the dissimilarities in age and history of cardiovascular diseases, male gender appeared as an independent predictor of death. Development of myocardial infarction occurred in 25% of the men and 16% of the women (P < 0.001) during 1 year. The symptoms that brought patients to the emergency room were interpreted as being caused by myocardial infarction or myocardial ischemia in 29% of men compared with 21% of women (P < 0.001).
In a consecutive series of patients with chest pain or other symptoms suggesting acute myocardial infarction in the emergency room, male gender was an independent risk indicator for death during 1 year. This might be explained by a higher occurrence of coronary artery disease in men than in women in this patient population.
先前的研究表明，缺血性心脏病患者的预后存在性别差异。在本研究中，我们旨在描述疑似缺血性心脏病患者的特征及与性别相关的预后情况。
在为期21个月的研究期间，前瞻性地对因胸痛或其他提示急性心肌梗死的症状前来某一家医院急诊室就诊的所有患者进行了为期1年的随访。
共7157人次收治了5362例患者；男性占收治人数的55%。男性的1年死亡率为11%，女性为10%。女性年龄更大，已知充血性心力衰竭和高血压的患病率更高，而男性既往心肌梗死的患病率更高。在校正年龄和心血管疾病史的差异后，男性性别是死亡的独立预测因素。1年内，25%的男性和16%的女性发生了心肌梗死（P<0.001）。因心肌梗死或心肌缺血而导致患者前往急诊室就诊症状的比例，男性为29%，女性为21%（P<0.001）。
在一系列因胸痛或其他提示急诊室急性心肌梗死症状而连续就诊的患者中，男性性别是1年内死亡的独立风险指标。这可能是由于在该患者群体中男性冠状动脉疾病的发生率高于女性。
