[Differences between men and women in fatal cases of myocardial infarction: study of 200 necropsies]. / Diferenças entre homens e mulheres em casos fatais de infarto do miocárdio. Estudo de 200 necrópsias.

ABSTRACT

PURPOSE: To compare morphological characteristics from myocardial infarction (IM) in men and women in 200 consecutive necropsies. MATERIAL AND METHODS: Necropsy heart findings from 62 female cases compared with those from 138 male cases, from patients who died from transmural myocardial infarction. Age ranged from 21 to 82 (mean 60) years. RESULTS: Concerning the coronary arteries, the number of 3 major (right, left anterior descending and left circumflex) epicardial coronary arteries narrowed at some point greater than 70% in cross-sectional area by atherosclerotic plaque was not significantly different; on the other hand, there were more severe lesions in the left main coronary artery in men (10.33%) than in women (1.64%) (p = 0.050). 33.33% of men and 43.55% of women had only recent myocardial infarction (1 month or less); 33.33% of men and 14.52% of women had only old myocardial infarction (more than 1 month); 33.33% of men and 41.94% of women had both recent and old myocardial infarction. 12.90% of women and 2.17% of men showed rupture of the left ventricle (p = 0.0220). 15.22% of men and 6.45% of women had left ventricular aneurysms (p = 0.830). CONCLUSION: There are more deaths during the acute phase of MI, in the first infarction and from rupture of the left ventricle in female patients; in men, there are more deaths occurring in chronic phases of the disease and with previous myocardial infarction; and more severe narrowing from the left main coronary artery.