Difference in the in-hospital mortality of unstable angina pectoris between men and women

Abstract

Purpose -To assess differences in the in-hospital mortality (HM) rate between men and women with unstable angina pectoris (UA) according to age, depression of the ST segment, history of previous acute myocardial infarction (AMI), and risk factors for coronary heart disease. =1.02-9.27. In logistic regression models, the association between sex and death was not significantly altered when the following parameters were considered: age, depression of the ST segment, history of previous AMI and risk factors for coronary heart disease. The nonadjusted and adjusted odds ratio (OR) for the distinct covariables were 3.28 , respectively. Numerous studies have consistently shown that mortality in acute myocardial infarction (AMI) is higher in women than in men [1][2][3][4][5][6][7][8][9] . There is evidence that some factors related to the female gender, such as advanced age at the time of hospital admission, a higher frequency of heart failure, a larger interval between symptom onset and hospital admission, and lesser access to medical care partially explain the higher mortality in women with AMI. In regard to unstable angina pectoris (UA), there are few studies comparing the prognosis between men and women, which is particularly amazing considering the large number of hospital admissions due to UA at cardiology services 10 . In addition, the risk of death during hospital admission for this group of patients can reach 5% to 10% 11 . These points motivated the present study, whose main purpose was to assess the possible association between sex and in-hospital mortality (HM) due to UA in a cardiology service in the city of Salvador in the Brazilian state of Bahia. Methods Conclusion MethodsAll patients in this study (n=261) were admitted to the Cardiology and Cardiovascular Surgery Unit of the Fundação Bahiana de Cardiologia (FBC), at the Hospital Universitário Prof. Edgar Santos, of the Federal University of Bahia. This hospital has a 24-hour emergency unit and is a referral service for the entire state of Bahia. Patients were prospectively and consecutively selected at the time of hospital admission to the Coronary Unit, from October 96 to March 98. Patients with one of the following characteristics were excluded from the study: those with elevated levels of CKMB in the first 12 hours after admission (these patients were considered to have evolving AMI); those patients remaining in the hospital for less than 48 hours free from events because the period of observation was considered too short; and those with diagnosis on hospital discharge different from UA because they did not have angiographic documentation of coronary heart disease (CHD) or objective evidence of spontaneous or provoked ischemia.Data collected were from the hospital phase of the UA, 674Passos et al In-hospital mortality of unstable angina in men and women Arq Bras Cardiol volume 72, (nº 6), 1999which is defined as precordial pain compatible with myocardial ischemia at rest (with or without electrocardiographic alteration) or progressive angina (i. e.,...

Síndromes coronarianas agudas na ausência de doença arterial coronariana significativa

“…The clinical and demographic variables of the patients were stored in the Epidemiology of the Acute Coronary Syndromes (EPICOR) databank, which represents the recording of all admissions due to acute myocardial infarction or unstable angina at the Coronary Unit of the Cardiology and Cardiovascular Surgery Unit of the Fundação Bahiana de Cardiologia 9 . The follow-up of patients proceeded from admission until hospital discharge, and all therapeutic and diagnostic interventions adopted were recorded, as were the complications and outcomes of the patients with the syndromes studied during the in-hospital phase.…”

"Fatores de risco em pacientes com infarto agudo do miocárdio em um hospital privado de Ribeirão Preto-SP"

“…Desse modo, o conhecimento da história familiar do paciente é um dado extremamente importante, uma vez que através destes dados pode-se estimar maiores riscos para a ocorrência do infarto agudo do miocárdio e, conseqüentemente, a implementação imediata da adoção de medidas que visam prioritariamente a sua prevenção. Nessa direção, a prática adequada e regular de atividade física têm sido admitida como uma das mais importantes e eficazes medidas para a prevenção da doença arterial coronariana e a preservação da saúde e da qualidade de vida das pessoas, considerando que um dos fatores de risco para as doenças coronarianas é o sedentarismo (PASSOS et al, 1999).…”

“…Além dos fatores de risco acima mencionados, diversos autores referem que os fatores de risco de maior prevalência para a doença coronariana e infarto agudo do miocárdio são a dislipidemia, sedentarismo, estilo de vida, tabagismo, estresse e história familiar (KOCH; SALERNO DE MINA, 1992;KANNEL, 1995;BODANESE, 1999;PASSOS et al, 1999;BERTUZZI et al, 2003).…”

“…Maior índice de mortalidade por infarto agudo do miocárdio tem sido encontrado em mulheres do que em homens com o incremento da idade. Esse fato deve-se à influência de fatores hormonais, associados a maior ocorrência de hipotiroidismo, doença pulmonar obstrutiva crônica, anemia ou coagulopatia nas mulheres (PASSOS et al, 1999).…”