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

pp. 417-425

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.