Muhammad Anis Memon, Abdus Samad.
Acute Myocardial Infarction in women - (Prospective study from a developing country: Pakistan).
Pak J Cardiol Jan ;10(4):95-107.

OBJECTIVES: The purpose of this study was to determine the gender related differences in the risk factor profile, clinical characteristics, in-hospital course and outcome of admitted patients with first episode of acute myocardial infarction(AMI). DESIGN: Prospective, observational study. SETTING: National Institute of Cardiovascular Diseases, Karachi, Pakistan. METHOD: Out of a total of 4731 patients admitted to NICVD from Jan 1994 to May 25, 1994, 1058 patients were included in this study with definite evidence of first episode of AMI (WHO Criteria). 241 (23%) were females, the rest were males (77%). RESULTS: Women were on average 6 years older than the men (59 vs 53 years, p <0.01). 11% of females patients were menstruating while 89% were non-menstruating. 7.3 % of our, patients were under the age of 40 years. 10% of women and 5% of men were obese (BMI). Women more frequently had hypertension (57% vs 27%, p <0.001), diabetes mellitus (34% vs 18%, p = 0.01) and preinfarction angina (19% vs 9%, p <0.01). More of the men were cigarette smokers (60% vs 5%, p <0.01). Women had more in-hospital complications (40% vs 29%, p <0.01), and mortality (15.4% vs 5.3%, p <0.01), while no significant differences in age adjusted mortality were noted in females as compared with males. Women were less likely than men to be eligible for thrombolytic therapy (44% vs 77%). Moreover, only 11% of women and 30% of men received thrombolytic therapy. CONCLUSION: Women were 6 years older than men and significantly more chances of having hypertension, diabetes mellitus, preinfarction angina, as well as high mortality. Age adjusted mortality was the same in both sexes. Women were less eligible for thrombolytic therapy and even in eligible women, thrombolytic therapy was given less likely than men. Asprin (97%), nitrates (95%), and IV heparin (77%) were used in the majority of patients regardless of their sex.

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