[Acute myocardial infarct--the hospital phase and follow-up: sex-related differences]. / Enfarte agudo do miocárdio--fase hospitalar e seguimento: diferenças relacionadas com o sexo.

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the differences between male and female patients, during hospitalization and follow-up, after acute myocardial infarction. PATIENTS The clinical data and follow-up files of 504 previously hospitalized patients were studied. The patients were divided in two groups Group A (male, n = 434) with a mean age of 56.4 +/- 11.7 years, and Group B (female, n = 70) with a mean age of 64.1 +/- 9.2 years. METHODS: The following parameters were studied vascular risk factors; clinical, functional and anatomic aspects during hospitalization; therapeutic orientation and events; and mortality during follow-up. RESULTS: Hypertension, diabetes, obesity, anterior infarction and lower ejection fraction were more common in Group B. Coronary angiography and thrombolytic therapy were performed more frequently in Group A; severe coronary disease was more common in this group (60.8% vs 38.9%, p < 0.05). During the follow-up we observed a worse prognosis in the Group B, with a higher incidence of events, morbidity and mortality. Therapeutic approach was more aggressive in the male group. CONCLUSION: We observed a worse prognosis in the female patients after myocardial infarction, this fact may be attributed to a later age and higher previous morbidity; the therapeutic and diagnostic procedures are generally less aggressive in females, who are consequently referred for revascularization with more advanced stages of disease, and therefore with higher morbidity and mortality, in the short and long term, even though multivessel coronary disease is more common in males. Thrombolytic therapy was administered and coronary angiography was performed more often in Group A, who had more severe coronary disease.