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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
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30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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ST-segment elevation myocardial infarction in women: Later diagnosis, worst outcome?
Session:
Posters 5 - Écran 9 - Doença Coronária
Speaker:
Carla Marques Pires
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Carla Marques Pires; Paulo Medeiros; Cátia Costa Oliveira; Isabel Durães Campos; Rui Files Flores; Ana Ferreira; João Costa; Carlos Galvão Braga; Nuno Antunes; Jorge Marques
Abstract
<p><strong>INTRODUCTION</strong>: There are gender-specific differences in the presentation and the outcomes of patients (pts) with ST-segment elevation infarction (STEMI). Although ischaemic heart disease develops on average 7 to 10 years later in women compare with men, it remains a leading cause of death in women and both genders must be managed in a similar way.</p> <p> </p> <p><strong>AIM</strong>: To compare the time from symptoms onset to STEMI diagnosis, in-hospital mortality and one-year mortality between genders.</p> <p> </p> <p><strong>METHODS</strong>: We analysed retrospectively 1215 STEMI pts admitted in our coronary care unit from June 2011 to May 2016. They were divided in two groups: group 1- STEMI pts of the female gender (n=267, 21,97%); group 2-STEMI pts of the male gender (n=948, 78,03%). For each group we evaluated the clinical characteristics and we compared the time from symptoms onset to STEMI diagnosis. We also compared the in-hospital mortality and the one-year mortality between genders.</p> <p> </p> <p><strong>RESULTS</strong>: STEMI patients of the female gender were older (69,4± 13,8 years vs 59,7 ± 12,7 years; p<0,001), had a higher prevalence of some cardiovascular risk factors, as hypertension (62,6% vs 47,9%; p<0,001) and diabetes (31,4% vs 18,6%; p<0,001), and a lower prevalence of smoking habits (14,2% vs 64,3%, p<0,001). There were not statistically significant differences regarding body mass index, hypercholesterolemia, cerebrovascular disease and previous myocardial infarction. The time from symptoms onset to STEMI diagnosis was significantly higher in the female gender (126 ± 168 min vs 105±144 min; p-0,026).</p> <p>We observed a higher in-hospital mortality in STEMI pts of the female gender (10,1% vs 3,5%; p<0,001). However, when adjusted to the confounding factors the gender was not a predictor of in-hospital mortality (OR adjusted=1,054; p-0,882).</p> <p>In addition, we evaluated the one-year mortality after discharge and found no statistically significant difference among genders (7,1% vs 9,2%; p-0,296).</p> <p> </p> <p><strong>CONCLUSION</strong>: In this STEMI population the time to diagnosis was significantly delayed in the female gender, making a lower clinical suspicion threshold probably advisable in women. Older age and a higher comorbidities burden can explain the higher in-hospital mortality in this group.</p>
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