management of acute coronary syndrome (ACS) in women of ... groups: group 1 included 249 females with acute myocardial infarction (AMI), group 2.
Open Access Research Journal, www.pieb.cz ISSN: 1804-1884 (Print) 1805-5014 (Online)
Medical and Health Science Journal, MHSJ Volume 5, 2011, pp. 10-15
CLINICAL COURSE, MANAGEMENT AND IN-HOSPITAL OUTCOMES OF ACUTE CORONARY SYNDROME IN CENTRAL ASIAN WOMEN The paper describes features history, risk factors and hospital management of acute coronary syndrome (ACS) in women of the Central Asia (829 ACS patients are included), and also comparison of hospital outcomes of ACS in groups of men and women. ACS in women in the Central Asia comprises features as more non Q-wave myocardial infarction frequency, smaller adherence to treatment of dyslipidemia, more obesity degrees. Women arrive to hospital average in 4 hours after men; have more percent of the atypical form. In-hospital outcomes in men and women significantly did not differ because of general tendency to late arriving to the hospital and small quantity of revascularization procedures. The reasons of differences between men and women in the region are mostly connected to social sphere (late arriving, non-treated dyslipidemia) than to physiological peculiarities.
ALEKSEY NIKISHIN, RAVSHANBEK KURBANOV, MAHMUDJON PIRNAZAROV
Republic Specialized Center of Cardiology, Uzbekistan
Keywords:
Acute coronary syndrome, in-hospital outcomes, risk factors, central Asian women.
UDC:
616.127-005.8-07-055.2-08-036.11-055.1
Introduction
Ischemia is known to be the leading cause of women mortality throughout the world. Recent research on emergency cardiology has revealed some peculiar features of the symptoms, course and prognosis of acute coronary syndrome (ACS) in women (Shaw, 2006, Sheifer et al., 2000). It is generally accepted that ACS women are typically elder and, hence, more often have hypertension, diabetes. However, the researches conducted by Vaccarino (1999) and Hochman (1999) have revealed new facts based on analysis of numerous data indicating the difference between males and females in ischemia course that are not related to age. Another “axiom” of ACS in women postulates on worse inhospital and long-term prognosis, although it was not acknowledged in some research (Alfredsson at al., 2007.). There are data showing that women undergo invasive intervention less often (Rathore et al., 2002); on discharge they receive less evidence-based recommendations; women run higher risk of diabetes mellitus. Thus, the problem of acute coronary syndrome in females has many poorly studied aspects, in Central Asian region in particular. The objectives of the study were to reveal characteristics of history data, clinical course, in-hospital management of acute coronary syndrome in Central Asian women and to compare the in-hospital ACS outcomes in the groups of males and females. Material and methods
This study included 829 patients with acute myocardial who were divided into two groups after randomization: group 1 (249patients) - the study group, which included patients of female sex central Asian origin, and group 2 (580 patients) - the control group, which included male patients with acute myocardial infarction. We identified Central Asian patients by their surnames and first names, and by using self-reported ethnicity and country of birth when available. Patients of Caucasian origin were excluded. To evaluate in-hospital outcome, the research involved patients with no age limitation who were admitted with the diagnosis “acute myocardial infarction” in 2008-2009. The diagnosis was verified according to the WHO criteria. The risk factors, the standard hospital outcomes, © 2011 Prague Development Center
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Medical and Health Science Journal / MHSJ / ISSN: 1804-1884 (Print) 1805-5014 (Online)
and also time characteristics (average arriving-to-hospital time, amount of the patients hospitalized at first 6 hours from ACS onset) were studied. Accumulation and correction of the findings were made using the standard software package of Microsoft Office Access 2003 for Windows XP. Reliability of the indicators’ difference was evaluated by χ² distribution test. The minimum sufficient significance was Р
