Risk factors and clinical angiographical characteristics of myocardial infarction in women.

Introduction: Myocardial infarction has a higher incidence in men. However, in women, although less frequent, it has a worse prognosis. Objective: With the present work we aim to define the clinical and angiographical characteristics and evolution of myocardial infarction in women compared with men. Methodology: We studied 235 sequential inpatients with acute myocardial infarction in the Intensive Care Unit who underwent post-infarction catheterization. We then compared female with male patients in terms of risk factors, location and type of infarction, coronary morphology and post-infarction complications. Results: About 22 % of the patients hospitalized following myocardial infarction were female. The women were older than the men (65.9′11.2 vs. 60.3′11.9; p<0.01), and had a higher prevalence of high blood pressure (71 % vs. 54%, p<0.05) and a lower prevalence of smoking (19% vs. 50%, p<0.001). Post-infarction angina was more frequent in women (50% vs. 23 %, p<0.001). Neither Q-wave versus non-Q wave myocardial infarction nor its location were significantly different between the sexes. In terms of coronary morphology, myocardial infarction without significant lesions was more frequent in women (10% vs. 3%, p<0.05) and there were no significant differences either in the number of lesions -single-vessel versus multivessel disease - or in the existence of proximal disease of the LAD or of any other major coronary artery. The need for PTCA or CABG during hospitalization was about the same in both sexes. Post-infarction complications - post-infarction angina, need for late revascularization and death from cardiac cause - were more frequent in women. The statistical difference for each item did not reach significance but the global difference was significant (p<0.001). Conclusions: In the sample studied of post-myocardial infarction patients, females present later onset of the disease, higher prevalence of high blood pressure, lower prevalence of smoking and higher rate of post-infarction angina. Overall, women presented more post-infarction complications.