ST-segment Elevation Acute Myocardial Infarction in Women in Argentina. Subanalysis of the CONAREC XVII Registry

Juan Pablo Costabel, Lucrecia M. Burgos, María P. Duczynski, Ignacio Cigalini, Casandra Lilen Godoy, Elián F. Giordanino, Sebastián García Zamora, Gonzalo Pérez, Nicolás González, Ricardo Iglesias

Abstract


Background: Acute myocardial infarction is one of the leading causes of death among women. Objective: The aim of this study was to analyze the characteristics of ST-segment elevation myocardial infarction in Argentine women. Methods: This was an observational study, performed with data from the CONAREC XVII registry. Results: The study included a total of 694 patients, among which 150 were women with mean age of 69.2±13.7 years vs. 59.9±11.5 years in men (p=0.001). Women presented a higher prevalence of diabetes (29.3% vs. 19.9%, p=0.010) while smoking was higher in men (71% vs. 45.3%, p=0.001). No differences were found in presentation symptoms, ischemia times, or reperfusion treatments. Women had a higher prevalence of single vessel lesions, with more Killip and Kimbal C-D infarctions (15.3% vs. 7.5% (p=0.001) and higher inotropic requirements [21.3% vs. 8.6% (p=0.001)]. In addition, they presented significantly higher percentage of bleeding and mechanical complications (4.7% vs. 1.3%, p=0.017) without differences in percent mortality. However, the multivariate analysis showed no relationship between female sex and poor hemodynamic evolution or complications. Conclusions: Women have a different cardiovascular risk profile, presenting ST-segment elevation myocardial infarctions with worse hemodynamic impact and greater in-hospital complications. Gender was not an element individually associated with this finding, but it seems to group a series of factors that imply worse tolerance to myocardial infarction.

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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar