| Objective To explore the influence of sex on patients with acute myocardial infarction(AMI),we collected and sorted clinical data and the prognosis in hospital and follow-up period.To explore risk factors and the features of the clinical patients with acute myocardial infarction(including acute ST segment elevation and acute non ST segment elevation myocardial infarction).In order to guide the prevention and treatment of different gender patients with AMI.Methods A total of 613 consecutive patients with AMI of Tianjin Medical University second hospital were enrolled in the study.The patients were hospitalized during August 2013 to October 2015.The risk factors,induced factors,clinical symptom,ECG classification,infarction area,adverse events during and after 1 year of hospitalization were analyzed between male and female patients.Results1 Clinical aspects and Laboratory analysis : The incidence of male group was significantly higher than that in the female group(72.9% vs27.1%,P< 0.001),and the age of female patients was significantly higher than that of the male group.The difference was about 8 years(65.2± 13.4 vs 73.8 ± 9.5,P< 0.001).RBC,HGB,Cr and SUA of male group were all significantly higher compared with female group.In this study,female patients with AMI had a higher prevalence of both diabetes mellitus and hypertension.Compared with male group,SBP,FIB,RDW,GLU,TC,HDL,LDL-C and Cys-C of female group were all significantly higher.2 Incentive : The male group had a clearer incentive than female group.The major induced factors of the male patiets were physical stress(50.1% vs 43.2%)and excessive unhealthy lifestyles(15.3% vs 8.9%).They both had statistical difference compared with the female group(P<0.05).3 Clinical symptoms : Male group were more with pectoralgia and sweat,than female group.Women with AMI suffered chest distress,nausea/vomiting,heart palpitations and persistent tooth/jaw pain were higher than the male group.There were significant differences between the two groups(P<0.05).4 Interventional therapy : Both the type of STEMI and the type of NSTEMI,men had more interventional treatment than women(P < 0.05).There was no significant difference of the numbers of pathological coronary vessels between the two groups(P>0.05).Compared with male group,Gensini scores of female ware higher(P<0.05).5 Type and location : According to ECG for AMI type,there was no significant difference in the type of acute myocardial infarction between the two groups.And on the basis of the ECG,there was no statistical differences in the aspect of the site of myocardial infarction between the two groups.6 Adverse events : Hospitalization period of female patients with AMI was significantly longer than that in the male group(9.9±5.8)days versus(8.4±5.0)days,(P<0.05).During the period of hospitalization,there was no statistically significant difference between the hospital mortality of two gpoups.However,there was statistically significant difference between the follow-up period mortality of two gpoups.The incidence of heart failure,non-lethal myocardial infarction and severe angina in female AMI patients was significantly higher than that in men both during both the period of hospitalization and follow-up.7 The cardiovascular death followed up of 1 year was looked as a dependent variable,and the statistically different Variables were looked as independent variables.It,s showed that four indicators of gender,age,LVEF and alcohol consumption were the independent risk predict factors for cardiovascular death in AMI(P< 0.05).And there was a significant correlation between the gender and the risk of cardiovascular death during the period of follow-up(OR=4.509,95%CI:1.504-13.519,P= 0.007).Conclusion1 The incidence of male group was significantly higher than that in the female group,but the incidence of heart failure,non-lethal myocardial infarction and severe angina in female AMI patients was significantly higher than that in men both during both the period of hospitalization and follow-up.2 The male group had a clearer incentive than female group.The major induced factors of the male patiets were physical stressand excessive unhealthy lifestyles.3 Severe chest pain and sweat remained the most common clinical manifestations of AMI,and the incidences of severe chest pain and sweat symptoms of male AMI were both higher than those of female.The indence of atypical symptoms of female AMI was higher than that of men.4 The proportion of female AMI patients receiving intervention was lower than that of male patients with AMI,and the degree of coronary artery disease in female AMI patients was higher than that of male patients.5 Compared with men,women with AMI were older,with high rates of hypertension and diabetes.6 There was no difference in both the type of AMI and infarction location of AMI patients with different genders.7 Hospitalization period of female patients with AMI was significantly longer than that in the male group.Compared with male with AMI,the Female group were more likely to have heart failure,non-lethal myocardial infarction and severe angina during both the period of hospitalization and follow-up.8 Four indicators of gender,age,LVEF and alcohol consumption were the independent risk predict factors for cardiovascular death in AMI.There was a significant correlation between sex and the risk of cardiovascular death during 1 year follow-up. |
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