[Clinical manifestations and acute myocardial infarction in women treated with primary coronary angioplasty].
OBJECTIVE
The differences in presentation, complications, and outcome of acute myocardial infarction treated with primary coronary angioplasty were compared in male and female patients.


METHODS
Consecutive patients with acute myocardial infarction who were admitted within 12 hr of onset underwent primary percutaneous coronary intervention, including 120 female (31%) and 264 male (69%) patients.


RESULTS
There were significantly more patients with diabetes mellitus (42% vs 31%, p = 0.03), and hyperlipidemia(56% vs 38%, p = 0.001), and fewer patients with current smoking (10% vs 60%, p < 0.0001) in the female group than in the male group (p < 0.01). The female group was significantly older (75 +/- 11 vs 67 +/- 12 years, p < 0.0001). The value of acute phase brain natriuretic peptide was significantly higher (483 +/- 543 vs 306 +/- 404 pg/ml, p = 0.001), and peak creatine kinase value was significantly lower (1,743 +/- 1,732 vs 2,855 +/- 2,997 IU/l, p = 0.0003) in the female group than in the male group. Both Killip's classification on admission (p = 0.04) and Thrombolysis in Myocardial Infarction grade soon after mechanical reperfusion therapy (p = 0.03) were significantly worse in the female group. There were significantly more patients with heart failure in the female group (40% vs 27%, p = 0.04). The cardiac mortality rates during 6 months was significantly higher in the female group (11% vs 5%, p = 0.02). However, multivariate analysis showed that female sex was not an independent predictor of cardiac death.


CONCLUSIONS
Female patients with acute myocardial infarction seemed to have a poor prognosis, in spite of lower peak creatine kinase value and higher brain natriuretic peptide value. The reasons for poorer outcomes in women were considered to be patient background, such as higher age and diabetes mellitus, and condition of heart failure on admission.
Katayama
Toshiro
T
Department of Cardiology, Kouseikai Hospital, Nagasaki. snowman-kt@syd.odn.ne.jp
Iwasaki
Yoshihiro
Y
Yamamoto
Tadashi
T
Yoshioka
Masato
M
Nakashima
Hiroshi
H
Suzuki
Shin
S
Yano
Katsusuke
K
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D048909:Diabetes Complications; D005260:Female; D006333:Heart Failure; D006801:Humans; D006949:Hyperlipidemias; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D003402:Creatine Kinase