MOTERŲ MIOKARDO INFARKTO KLINIKINĖS SIMPTOMATIKOS IR BAIGČIŲ YPATUMAI

Abstract

Objective. The aim of the present study was to compare differences of symptoms, comorbidities, risk factors and outcomes in younger (up to 55 years-old) and older (over 55 years-old) women with acute myocardial infarction. Materials and methods. In this retrospective study we analised 473 cases of women with acute myocardial infarction treated in 2012. Patients were divided into two groups according to their age: group I (up to 55 years) and group II (older than 55 years). The first group included 37 patients while the second group - 436 patients. Results. The average age of patients was 72,3 ± 11,07 m. Myocardial infarction with ST elevation were diagnosed to 54,3%, of wich Q+ 70,4%, Q- 29,6% (p 0,001), non-ST elevation 45,7%, of wich Q+ 6,5%, Q- 93,5% (p 0,001), no statistically significant difference was observed between the groups. 73% women in group I had primary arterial hypertension (I grade 2,7%, II 59,5%, III 10,8%), in the second group - 92,7% (I grade 0,7%, II 86%, III 6%), (p 0,001). Moreover, 13,5% patients in group I had diabetes (5,4% of type I, 8,1% of type II), in the group II 23,9% (0,3% of type I, 23,6% of type II), (p 0,001). Heart rhythm disorders were more often in women over 55 years-old (32,8%), (p=0,006). Among these patients, persistent atrial fibrilation were identified in 27,2%, permanent atrial fibrilation in 18,4%, ventricular fibrilation in 4,1% patients (all p 0,001). 5,4% women in younger group had previously experienced myocardial infarction while in older group - 20% (p=0,03). The spread of the pain to left hand was more common in the group of younger patients (27%) (p=0,047). Futhermore, in group I 18,9% felt weakness, while in group II - 38,5% (p=0,018). Fatal outcomes were observed in 6,8% patients, all of them were older than 55 years. Among patients with fatal outcomes Killip IV were found to 78,1% patients (p 0,001). Conclusions. Older women (≥ 55 years-old) treated for acute myocardial infarction more often had the grade II of primary arterial hypertension, heart rhythm disorder, previously experienced mycardial infarction and felt weakness. Younger patients (below 55 years old) had type I diabetes more often and were characterized by pain spreading to the left arm. Determined Killip IV leaded to increased lethality.