Myocardial Infarction in Women

Abstract

The leading cause of death in the United States is cardiovascular disease, regardless of gender. Women will more often have angina preceding their first myocardial infarct, but have more unrecognized infarctions than men. Women will be older, have more concomitant disease and present later in the course of their acute myocardial infarction. Although myocardial infarction may have similar clinical presentations in men and women, there are some important differences such as an increased incidence of non Q-wave myocardial infarctions in women, and the higher rate of complication and immortality from a myocardial infarct. Women develop less collateral cardiac vessels, which may explain the increased rate of hemodynamic complications after a myocardial infarct. Both early and late survival rates are also affected by the advanced mean age of women when they do present with a myocardial infarct. There is less data regarding treatment modalities based upon gender differences but in general, it appears that women benefit from established treatment modalities in the acute setting and subsequent to the event. It has been determined that there are epidemiologic differences, but pathophysiologic and clinical factors specific to women in this setting have yet to be determined.

Unveiling gender differences in demand ischemia: a study in a rat model of genetic hypertension

“…Therefore, physiological levels of estrogen in normotensive animals seem not to exert any protective or deleterious effect. In humans, female gender is associated with worse prognosis in acute coronary syndromes [8,9]. Our data suggest that differences in co-morbidity and other factors (e.g.…”

“…Female gender is also associated with greater susceptibility to acute ischemic syndromes [8]. Data from the US National Registry of Myocardial Infarction clearly indicate that there is a gender-based difference in mortality: among patients with less than 50 years of age, mortality rate for women is twice that for men [9].…”

Childhood adversities as predictors of incident coronary heart disease and cerebrovascular disease

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Age- and gender-related differences in drug utilisation and adverse drug reaction patterns among patients in a coronary care unit

“…(2) Although men are more likely to have episodes of myocardial infarction (MI), women who do suffer an episode of MI are more likely to have a second MI, develop heart failure, or suffer subsequent sudden cardiac death. (3) Increasing age, lipid abnormalities, high blood pressure, obesity, DM and smoking are major risk factors for CVDs in both genders. (4) Data from the INTERHEART study indicates that the lower prevalence of acute coronary syndrome (ACS) among women of younger ages (i.e.…”