Acute myocardial infarction: gender specifics of development and clinical course in an urban Western Siberian population

Abstract

Aim. To study the gender specifics of acute myocardial infarction (AMI) among the adult population (age >20 years) of Tomsk City. Material and methods. In total, 1628 AMI cases from the AMI Register (2007-2008) were analysed. The study included 992 (60,82%) men and 636 (39,18%) women. Results. Compared to male patients, AMI in women typically developed in older age (over 60 years), was preceded by various forms of progressing angina pectoris, and associated with severe co-morbidities and pre-existing disease. Its clinical course was characterised by a high risk of recurrent MI, various complications, and in-hospital death. The leading causes of in-hospital death in women with AMI included cardiogenic shock, congestive heart failure, and myocardial rupture, in contrast to cardiac arrhythmias and cardiac blocks in their male peers. Conclusion. The observed specifics of AMI development and clinical course in women could be both a barrier for a wider use of modern invasive treatment methods and an explanation of adverse prognosis. The AMI management guidelines should take into account gender-specific characteristics of the disease.

Keywords

• acute myocardial infarction
• gender specifics