Professional paper
GENDER DIFFERENCES IN THE INCIDENCE AND CLINICAL PRESENTATION OF ACUTE MYOCARDIAL INFARCTION IN EMERGENCY MEDICINE
ANTONIJA MIŠKOVIĆ
orcid.org/0000-0002-8483-3856
; Department of Emergency Medicine of the Brod-Posavina County, Slavonski Brod, Croatia
JOSIP GLAVIĆ
; Department of Emergency Medicine of the Brod-Posavina County, Slavonski Brod, Croatia
MISLAV OMERBAŠIĆ
; Department of Emergency Medicine of the Brod-Posavina County, Slavonski Brod, Croatia
BRANKA BARDAK
; Department of Emergency Medicine of the Brod-Posavina County, Slavonski Brod, Croatia
Abstract
The main objective of this study was to investigate whether there are gender differences in the incidence, age, distribution and clinical presentation of patients with acute myocardial infarction requiring emergency medical intervention. Retrospective analysis of the data base of our Department of Emergency Medicine from April 2014 to October 2019 was performed. We used the e-Hitna program and included all patients with acute myocardial infarction (I21 according to the ICD-10 classifi cation). For all patients involved, we analyzed the following characteristics: age, gender, presence of diabetes, and three clinical characteristics (chest pain, disorders of consciousness, and hemodynamic instability). A total of 377 patients with acute myocardial infarction were included. There were 219 (58.1%) men and 158 (41.9%) women (p<0.001). The average age of men and women was 64 and 73 years, respectively (p<0.001). There was no gender difference in the incidence of diabetes (p=0.88). Regarding clinical characteristics of patients, there was no difference in the incidence and severity of chest pain (p=0.07) and hemodynamic instability (p=0.49). However, women were found to be more likely to have a disorder of consciousness (62.2%) than men (37.8%) (p<0.01). In conclusion, acute myocardial infarction is more common in men, as confi rmed by numerous studies. Our study shows that myocardial infarction occurs in older women, with a 9-year difference in the average age. Such a difference is interpreted by different infl uence of risk factors for the development of cardiovascular diseases between the genders and the protective effect of estrogen in women before menopause. Of these clinical characteristics, consciousness disorders occur more frequently in women, which is consistent with numerous studies reporting that women have atypical symptoms more often. In conclusion, cardiovascular diseases occur more frequently in men, but are the leading cause of death in both genders. Men have myocardial infarction 10 years earlier on average, but gender differences are decreasing with age. Further studies on the cause of differences in the clinical presentation of acute myocardial infarction between genders are required.
Keywords
acute myocardial infarction; gender differences; emergency medicine
Hrčak ID:
245744
URI
Publication date:
6.11.2020.
Visits: 1.780 *