THE ROLE OF GENDER FEATURES IN ACUTE MYOCARDIAL INFARCTION

Objective: investigation of gender features and their role in progression and treatment of acute myocardial infarction (MI).

Materials and methods. 244 patients aged 30–85 (mean age 61.2 ± 12.3) with MI were included in this study. They were divided into 2 groups depending on their gender: the 1st group was comprised of 80 (32.8 %) women, the 2nd group – of 164 (67.2 %) men. We evaluated patients’ demographic data, diagnosis and its complications, comorbidities, medical history and risk factors (RF) of coronary heart disease (CHD), in-patient therapeutic activities, in-hospital mortality rate, and 12-month mortality rate after MI.

Results. In women MI was significantly more often associated with arterial hypertension (p < 0,01), diabetes mellitus (p < 0,05) and obesity (p < 0,05); prevalence of smoking was higher among men (p < 0,01).The most common MI complication in both groups was acute heart failure (HF), registered in 53.7 % of females and 55.5 % of males (relative risk (RR) 0.96; 95 % confidence interval (CI) 0.75–1.23; p > 0,05), however severe (class III–IV) heart failure was more common in female population (31.2 % vs 23.7 %; RR 1.31; 95 % CI 0.85–2.01; p > 0.05).Mortality rate was higher in women than in men (27.5 % vs 15.2 %; RR 1.8; 95 % CI 1.08–2.99; р < 0,05), the same trend was observed both for their in-hospital mortality (18.7 % vs 9.1 %; RR 2.05; 95 % CI 1.05–3.98; р < 0,05) and post-discharge mortality (8.7 % vs 6.1 %; RR 1.43; 95 % CI 0.56–3.63; р > 0.05). During the first 6 months after MI we found a tendency of higher mortality rate in females than in males (6.2 % vs 1.8 %; RR 3.41; 95 % CI 0.83–13.9; p > 0.05), but after 6–12 months after discharge males tended to have higher mortality than females (4.3 % vs 2.5 %; RR 0.58; 95 % CI 0.12–2.75; p > 0.05).

Conclusion. The most important risk factors for MI in females are diabetes mellitus, arterial hypertension and obesity. MI in women is associated with severe HF development; their immediate prognosis and disease outcome is usually less favorable, than in men.