Differences between men and women in terms of clinical features of ST-segment elevation acute myocardial infarction.
BACKGROUND
Many studies have examined sex-related differences in the clinical features of acute myocardial infarction (AMI). However, prospective studies are scant, and sex-related differences in symptoms of AMI remain unclear. We examined differences between men and women in terms of the clinical features of ST-segment elevation AMI.


RESULTS
We studied 457 patients (106 women and 351 men) with ST-segment elevation AMI who were admitted within 24 h after symptom onset. The same cardiologist interviewed all patients within 48 h after admission. Women were older than men (72 vs 62 years, p<0.001) and had higher rates of hypertension (70 vs 56%, p=0.010), diabetes mellitus (36 vs 26%, p=0.047), and hyperlipidemia (51 vs 38%, p=0.019). Women were more likely than men to have non-specific symptoms (45 vs 34%, p=0.033), non-chest pain (pain in the jaw, throat, neck, shoulder, arm, hand, and back), mild pain (20 vs 7%, p<0.001), and nausea (49 vs 36%, p=0.013). On coronary angiography, the severity of coronary-artery lesions was similar in both sexes. In-hospital mortality was significantly higher in women than in men (6.6 vs 1.4%, p=0.003).


CONCLUSIONS
Clinical profiles and presentations differ between women and men with AMI. Women have less typical symptoms of AMI than men.
Kosuge
Masami
M
Division of Cardiology, Yokohama City University Medical Center, Japan.
Kimura
Kazuo
K
Ishikawa
Toshiyuki
T
Ebina
Toshiaki
T
Hibi
Kiyoshi
K
Tsukahara
Kengo
K
Kanna
Masahiko
M
Iwahashi
Noriaki
N
Okuda
Jyun
J
Nozawa
Naoki
N
Ozaki
Hiroyuki
H
Yano
Hideto
H
Nakati
Tatsuya
T
Kusama
Ikuyoshi
I
Umemura
Satoshi
S
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000175:diagnosis / Q000503:physiopathology; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006334:Heart Function Tests; D017052:Hospital Mortality; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology; D010147:Pain Measurement; D011446:Prospective Studies; D012727:Sex Characteristics; D015996:Survival Rate