Analysis of myocardial infarction time course in women compared with men in Upper Silesia population in 30 day follow-up.

The aim of the study was to compare the course of myocardial infarction in women versus men in Upper Silesia, an industrial region in the south of Poland. The study comprised 1003 patients with either ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). The patients were divided into group 1 (300 females) and group 2 (control, 703 males). The groups differed significantly with respect to age, incidence of hypertension, diabetes, and smoking. In group 1 STEMI occurred significantly less frequently than NSTEMI. Taking this into account, we divided the studied cohort into group A (STEMI patients) and group B (NSTEMI patients), each subdivided into women and men. In the 30 day long follow-up, group 1 patients had significantly lower creatine kinase activity, higher occurrence of ventricular tachycardia, lower percentage of intra-aortic balloon pump use, and longer hospital stay compared with group 2. Group 1 was characterized by significantly higher mortality and target lesion reocclusion (TLR). The medical course of myocardial infarction in women is similar to that in men, as is the treatment of acute coronary syndrome. In our study, patients from both groups underwent invasive examination with consecutive interventional treatment with similar frequency. However, this finding is not reflected in the outcomes. Women had higher risks of death and TLR in 30 day follow-up. Taking this into consideration, we should attempt to identify the factors responsible for this situation by expanding the analysis to a larger population to allow firm conclusions to be drawn.

[Interventional treatment of myocardial infarction. Own experience]. / Interwencyjne leczenie zawalu miesnia sercowego. Doswiadczenia wlasne.

UNLABELLED: The aim of the study is the analysis of own results of myocardial infarction treatment using percutaneous coronary intervention (PCI) in the setting of twenty-four hour long hemodynamic service. Between 01.12.1998 and 31.12.2001 249 patients with diagnosis of acute myocardial infarction were admitted to our Department. Their mean age was 58 years, men -73.5%, median of pain duration was 4 hours, diabetes occurred in 11.6%, hypertension in 37.3%, dyslipidemia occurred in 14%, smokers constituted 59% of patients. 60.2% of patients were in Killip class I, 18.5% in class II, 8.0% in class III and 13.3% in class IV. Anterior and/or lateral myocardial infarction was diagnosed in 105 patients, inferior and/or posterior in 144 patients. Angiography was performed in 225 patients, PCI was performed in 178. TIMI 3 flow was achieved in 76% of patients with shock and 90% of patients without shock. Multivessel coronary artery disease was present in 71% of patients. 30-day mortality in patients treated with PCI was 11.8%, after exclusion of III and IV Killip class patients mortality was 4.3%. 30-day mortality in group of patients with cardiogenic shock was 38.0%. Relative risk of death in patients in III and IV Killip class was higher for these treated conservatively: IV class -1.51 (p = 0.075), III and IV class (common group) -1.38 (p = 0.064). In the year of 2001 30-day mortality among the patients in I and II Killip class treated with PCI was 2.43%. CONCLUSIONS: 1. Primary percutaneous coronary intervention in the treatment of myocardial infarction improves prognosis in group of patients with cardiogenic shock in 30-day observation. 2. 11.8% mortality observed in our PCI treated group is associated in our opinion with occurrence of multivessel coronary disease in 71% of patients.