Gender differences in case fatality rates of acute myocardial infarction in Serbia
Por:
Vasiljevic, Z, Krljanac, G, Davidovic, G, Panic, G, Radovanovic, S, Mickovski, N, Srbljak, N, Markovic-Nikolic, N, Curic-Petkovic, S, Panic, M, Cenko, E, Manfrini, O, Martelli, I, Koller, A, Badimon, L, Bugiardini, R
Publicada:
1 ene 2014
Resumen:
We sought to investigate sex differences in clinical characteristics, treatment and in in-hospital mortality in patients admitted with ST elevation myocardial infarction (STEMI) in Serbia. From October 2010 to September 2013, a total of 2348 patients have been hospitalized and received medical treatment for STEMI in 19 hospitals, referring data to the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS-TC) registry. There were 773 women and 1575 men. Women were older than man, with a higher prevalence of family history of coronary artery disease, hypertension, and diabetes. They were less likely to be smokers and more likely to have a prior angina and history of heart failure. Fewer women than men presented within 2 h from symptom onset (P = 0.005). They presented more with Killip class >= 2 than men (P = 0.004). A significantly lower proportion of women was treated with aspirin (91.3% vs 94.3%, P = 0.007), clopidogrel (88% vs. 91%, P = 0.02), heparins (61.6% vs. 66.5%, P = 0.01) and primary percutaneous coronary interventions (62.1% vs. 69.7%, P < 0.001). The in-hospital mortality was significantly higher for women than for men (13.2% vs. 6.4%, P < 0.001). After adjustment for any confounders, women showed an increased risk of in-hospital mortality (odds ratio: 1.97, 95% confidence interval: 1.28-3.01, P = 0.002). Several factors contribute to the excess in-hospital case fatality rates in Serbian women. Most notably disparities in medical treatment appear to play a crucial role.
Filiaciones:
Vasiljevic, Z:
Univ Clin, Clin Ctr Serbia, Fac Med Belgrade, Clin Cardiol, Belgrade, Serbia
Krljanac, G:
Univ Clin, Clin Ctr Serbia, Fac Med Belgrade, Clin Cardiol, Belgrade, Serbia
Davidovic, G:
Univ Clin, Clin Ctr Kragujevac, Med Fac Kragujevac, Kragujevac, Serbia
Panic, G:
Univ Clin, Clin Ctr Sremska Kamen, Fac Med, Novi Sad, Serbia
Radovanovic, S:
Clin Hosp Ctr Bezanijska Kosa, Belgrade, Serbia
Mickovski, N:
Inst Publ Hlth Dr Milan Jovanov Batut, Belgrade, Serbia
Srbljak, N:
Gen Hosp Kosovska Mitrov, Bezanijska, Serbia
Markovic-Nikolic, N:
Clin Hosp Ctr Zvezdara, Belgrade, Serbia
Curic-Petkovic, S:
Gen Hosp Ctr Zrenjanin, Belgrade, Serbia
Panic, M:
Univ Clin, Clin Ctr Sremska Kamen, Belgrade, Serbia
Cenko, E:
Univ Bologna, Cardiol Sect, Dept Expt Diagnost & Specialized Med, Bologna, Italy
Manfrini, O:
Univ Bologna, Cardiol Sect, Dept Expt Diagnost & Specialized Med, Bologna, Italy
Martelli, I:
Univ Bologna, Cardiol Sect, Dept Expt Diagnost & Specialized Med, Bologna, Italy
Koller, A:
Univ Pecs, Dept Pathophysiol & Gerontol, Pecs, Hungary
Univ Pecs, Szentagothai Res Ctr, Pecs, Hungary
Badimon, L:
Autonomous Univ Barcelona, Cardiovasc Res Ctr, Hosp Santa Creu & St Pau, CSIC ICCC,CiberObn Inst Carlos 3, Barcelona, Spain
Bugiardini, R:
Univ Bologna, Cardiol Sect, Dept Expt Diagnost & Specialized Med, Bologna, Italy
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