Gender Based Differences in Clinical Features and Mortalities in One-month Duration in Acute ST Elevation Myocardial Infarction Patients

Abstract

Summary C ardiovascular diseases, and within them acute myocardial infarction (AMI), have been the greatest health problem and the main cause of death in many countries during several decades. Acute coronary syndromes include a variety of clinical scenarios ranging from unstable angina and ST elevation myocardial infarction to non ST elevation myocardial infarction. Many new pharmacological and technical approaches to acute coronary syndromes have been introduced into clinical practice in recent years. This has resulted in a significant heterogeneity in the management and treatment of patients with acute coronary syndromes. However, in Egypt, a few registries are available till now despite the overwhelming increase in the number of ischemic heart disease patients and the change in the natural history of the disease affecting certain classes of patient's particularly young age and women. Therefore, we aimed by this study to establish a simple system for registering sex-related differences in terms of the clinical feature, demographics, and outcomes of patients admitted to the coronary care unit with acute ST-segment elevation myocardial infarction in Ainshams hospital. The present study included 80 consecutive patients (with ST-segment elevation MI within 24 h after symptoms onset) from June 2015 to September 2015, 62.5% males and 37.5 % females then subjected them to history taking, analysis of special habits, clinical examination, ECG, cardiac enzymes analysis, Echocardiography and hospital stay duration, then we classified those patients according to sex into 2 groups; group A (Males) and group B (Females). Female patients were relatively older than males and had higher rates of unfavorable risk factors like Diabetes and hypertension, whilst male patients were more cigarette smokers. Most males presented with Killip I and most females presented with Killip ≥ II. Generally, males presented to hospital earlier than females, most males presented with typical chest pain and most females presented with atypical chest pain. In our studied group, reperfusion was the aim using primary PCI. Medical treatment according to guidelines was prescribed extensively in our study, male and female were receiving same medical treatments. Finally, Females patients stay in hospital longer than males. About 30 days’ mortalities, it was more in females than males, five females died in comparison with one male died in this study.