Impact of sex difference in clinical presentations, therapeutic characteristics in patients with acute myocardial infarction

• Main Authors: Yi-HuiLin, 林怡慧
• Other Authors: Kow-Tong Chen
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/2ut7kf

碩士 === 國立成功大學 === 公共衛生研究所 === 102 === Impact of sex difference in clinical presentations, therapeutic characteristics and in-hospital outcome in patients with acute myocardial infarction Lin Yi-Hui Chen Kow-Tong Hsieh Tung-Han Department of Public Health College of Medicine National Cheng Kung University SUMMARY This study was based on hospital-base population at a medical center in the south of Taiwan from 2007 to 2010,for patients with discharge diagnosis of acute myocardial infarction ICD-9-CM codes 410. The aim of this study was to determine the characteristics of AMI by sex. We used chart review and chi-square test, fisher’s exact test, independent sample t test, logictic regression for statistic anlyzing. Females were more likely to have atypical symtroms, older age, history of diabetes mellitus and chronic kidney disease, higher incidence of complications and hospital fatality than males. Key words: acute myocardial infarction, sex, chest pain, atypical symptoms, hospital case-fatality INTRODUTION Cardiovascular diseases (CVDs) remain the biggest cause of deaths worldwide, account for 1/3 of all cause of deaths and it is responsible for 17.3 million of the cardiovascular deaths. Of the cardiovascular deaths, in the ischaemic heart diseases, there were up to 7.3million people died with acute myocardial infarction (AMI) which was remained the most important cause of deaths. In the developed countries, gender plays a major role of different morbidities, clinic presentations and prognosesof AMI. However, few studies wad done in Taiwan. The aim of this study was to determine the characteristics of AMI by sex. MATERIALS AND METHODS This study was based on hospital-base population at a medical center in the south of Taiwan from 2007 to 2010. Patients with discharge diagnosis of acute myocardial infarction ICD-9-CM codes 410 were enrolled in our study. For the categorical variables, we used chi-square test and fisher’s exact test and for the countiunable variables we used independent sample t test to analyze the variables. RESULTS AND DISCUSSION A total of 216 patients was erolled in our study. Among them, 157 cases were male (72.7%) and 59 cases were female (27.3%). Women were older than men with average age 71.14 years vs. 62.34 years. Females had significantly higher proportion of history of diabetes mellitus than that of males had (52.5% vs. 33.1%) and more likely to present with atypical symtroms than males had (47.5% vs. 21.7%). In multiple analyzing showed, females were more likely to had chronic kidney disease history, complications which especially were heart failure, pneumonia/other infections, acute renal failure and also had significantly higher proportion of hospital case-fatality. Finally, in logistic regresstion models we found out that sex, not do PCI surgery will have higher risk of hospital case-fatality. CONCLUSION Females were more likely to have atypical symtroms, older age, history of diabetes mellitus and chronic kidney disease, higher incidence of complications and hospital fatality than males. Patients who were without echocardiography and had complications had higher risks to have hospital fatality. In the future, early diagnosis or detecting the complications (ex. pneumonia) and doing PCI surgery are important to decrease the hospital case-fatality.