RT-239
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Sudden and expected death after
acute myocardial infarction. The impact of sex differences
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Miran F. Kenda, Josip Turk, Janez
Stare, Marija Rebolj, Janez Demšar.
University Medical Centre, Clinic of Cardiology, Ljubljana, Slovenia
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Abstract
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We analysed a group of 1067 pts; 770 males (M),
average age 59 ± 11 years, and 297 females (F), average age 67 ± 11, discharged from the
UMC Ljubljana after acute myocardial infarction (AMI) to find out the cause of death
(sudden or expected) and to compare the results between men and women in a fifteen-year
period. We found out that mortality after AMI is strongly correlated with age. Concerning
sudden and expected death, we analyzed a group of 554 pts, 198 pts (36%) , average age 69
± 11, who died suddenly and 356 pts (64%), average age 73 ± 10, who died expectedly. The
age difference is statistically significant (p = 0.030). The percentage of sudden death in
M (37%) was higher than in F (34%); however, the difference is not statistically
significant. Comparing the results regarding sudden and expected death in M, the suddenly
deceased were younger: 66 vs 71 years (p = 0.000), as well as suddenly deceased C:\WWW 74 vs
75 years (ns). The survival curves for suddenly or expectedly deceased did not show any
significant differences.
We stated that crude mortality in post-infarction period was higher in C:\WWW 189 (64%)
than in M: 365 (47%), (p = 0.000). Analyzing the major covariates, we stated that the
percentage of congestive heart failure (p = 0.004), diabetes (p = 0.000), hypertension (p
= 0.002) and ventricular tachycardias (p = 0.035) was significantly higher in deceased
women than in men. Concerning therapy, we found out that females took significantly less
drugs (aspirin, beta-blockers and nitrates) and have significantly less coronary artery
bypass graftings than males. These findings and the fact that F were about ten years older
than M when suffering from AMI could be the explanation for a relatively worse prognosis
for women after AMI.
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Key Words
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Cardiac arrhythmias - gender differences
postmyocardial infarction, crude mortality, congestive heart failure, diabetes,
hypertension, ventricular arrhythmias, aspirin, beta-blockers, nitrates, coronary artery
bypass graftings, OA
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