Gender peculiarities of clinical and instrumental indexes in patients with acute Q-wave myocardial infarction after primary coronary intervention
DOI:
https://doi.org/10.14739/2310-1210.2021.5.231570Keywords:
myocardial infarction, percutaneous coronary intervention, myocardial reperfusion, gender differencesAbstract
The aim: to determine gender differences in the course of acute Q-wave myocardial infarction in patients after primary coronary intervention.
Materials and methods. Results of clinical and instrumental examination of 58 patients with acute Q-wave myocardial infarction were analyzed. Patients were divided into 2 groups according to gender: group 1 (n = 33) – men, mean age 61.0 (55.0; 69.0) years, group 2 (n = 25) – women, mean age 69.0 (63.0; 78.0) years. All the patients underwent coronary angiography followed by angioplasty and stenting of the infarct-dependent coronary artery.
Results. In men, the number of leukocytes was significantly higher (by 24.7 %, P = 0.02) and the plasma level of low-density lipoproteins was significantly lower (by 30.9 %, P = 0.007), there was a tendency towards a higher concentration of creatine kinase-MB (by 41.0 %, P = 0.11) at the time of hospital admission as compared to women. Women showed significantly increased thickness of the posterior wall of the left ventricle (LV) (by 7.31 %, P = 0.02) and a tendency towards the prevalence of the interventricular septum wall thickness (by 7.46 %, P = 0.1). The LV end-diastolic and end-systolic dimensions tended to prevail in men (by 2.41 %, P = 0.47 and by 7.81 %, P = 0.19, respectively). Men were found to have a lower peak A rate (by 23.37 %, P = 0.007), a higher E/A ratio (by 52.27 %, P = 0.009), LV diastolic dysfunction (DD) occurred less frequently (χ2 = 2.89, P = 0.08), and there was a tendency to develop eccentric LV hypertrophy (χ2 = 2.39, P = 0.12) and type 2 LV DD (χ2 = 3.82, P = 0.07). Type 1 DD was more common in women (χ2 = 5.71, P = 0.02). In men, there was a tendency to the formation of zones of LV akinesia (χ2 = 2.5, P = 0.09) and decreased LV ejection fraction (χ2 = 1.57, P = 0.31).
Conclusions. In the acute period of Q-wave myocardial infarction after revascularization, in men, unlike in women, systolic dysfunction is developed more often. It is accompanied by acute left ventricular failure, eccentric left ventricular hypertrophy and type 2 diastolic dysfunction formation as well as signs of systemic inflammation. In women, in the acute period of Q-wave myocardial infarction after revascularization, concentric left ventricular remodeling occurs more frequently and is accompanied by type 1 left ventricular diastolic dysfunction.
References
Baranova, O. L. (2020). Kaltsyfikatsiia aortalnoho klapana: henderni osoblyvosti perebihu, strukturno-funktsionalnoho stanu sertsia i metabolichnoho statusu (Dis… dokt. med. nauk). [Aortic valve calcification: gender differences in the course, structural and functional state of the heart and metabolic status. Dr. med. sci. diss.]. Vinnitsa. [in Ukrainian].
Amosova, K. M., Cherniaieva, K. I., Rudenko, Yu. V., Mostbauer, G. V., & Lazareva, K. P. (2018). Vikovi ta henderni vidminnosti fenotypu sertsevoi nedostatnosti zi zberezhenoiu fraktsiieiu vykydu livoho shlunochka u patsiientiv z arterialnoiu hipertenziieiu [Age and gender differences in phenotype of heart failure with preserved left ventricular ejection fraction in patients with arterial hypertension]. Sertse i sudyny, (4), 53-61. http://doi.org/10.3978/HV2018-4-53 [in Ukrainian].
Kenjaev, M. L., Alyavi, A. L., Kenjaev, S. R., Sattarov, KH. I., & Rakhimova, R. A. (2017). Vliyanie vysokikh doz atorvastatina na miokardial'nyi stanning i pokazateli remodelirovaniya levogo zheludochka pri ostrom infarkte miokarda [The influence of atorvastatin’s high doses on myocardial stanning and indices of left ventricle remodeling at acute cardiac infarction]. Vestnik ekstrennoi meditsiny, 10(1), 36-40. [in Russian].
Dolzhenko, M. M., & Yakovenko, L. I. (2019). Henderni aspekty sertsevo-sudynnykh zakhvoriuvan [Gender aspects of cardiovascular disease]. Liky Ukrainy, (8), 31-35. https://doi.org/10.37987/1997-9894.2019.8(234).187187 [in Ukrainian].
Vakaliuk, I. P., & Iyad Ali Ibrahim Alghzawi. (2019). Holovni chynnyky kardiovaskuliarnoho ryzyku v khvorykh na hostryi infarkt miokarda z pidiomom sehmentu ST [The main cardiovascular risk-factors in patients with acute myocardial infarction with st elevation]. Visnyk problem biolohii i medytsyny, (2. Pt. 2), 91-93. https://doi.org/10.29254/2077-4214-2019-2-2-151-91-93 [in Ukrainian].
Feldman, D. A. (2019). Henderni osoblyvosti sertsevo-sudynnykh zakhvoriuvan [Identity politics through the eyes of Ukrainian youth]. Gender policy through the eyes of Ukrainian youth: materials of the final conference of the XII Regional Scientific Competition of Young Scientists. (pp. 61-67). KhNUMH im. O. M. Beketova. [in Ukrainian].
Ivanov, V., & Onyshchuk, T. (2019). Statevi ta vikovi osoblyvosti remodeliuvannia livykh kamer sertsia u khvorykh na arterialnu hipertenziiu [Gender-and age-specific peculiarities of left heart remodeling in patients with arterial hypertension]. Eastern Ukrainian Medical Journal, 7(3), 194-207. https://doi.org/10.21272/eumj.2019;7(3):194-207 [in Ukrainian].
Kyselov, S. M., & Savchenko, Yu. V. (2020). Klinichni osoblyvosti perebihu hostroho periodu infarktu miokarda z elevatsiieiu ST u patsiientiv pislia reperfuziinoi terapii [Clinical features of the acute period of myocardial infarction with ST segment elevation in patients after reperfusion therapy]. Zaporozhye medical journal, 22(5), 597-603. https://doi.org/10.14739/2310-1210.2020.5.214720 [in Ukrainian].
Shved, M., Tsuglevych, L., & Heryak, S. (2019). Klinichna efektyvnist kardiotsytoprotektornoi terapii u khvorykh na hostryi koronarnyi syndrom (infarkt miokarda), yakym provedeno balonnu anhioplastyku ta stentuvannia koronarnoi arterii [Clinical effectiveness of cardioсytoprotective therapy in patients with acute coronar syndrome (acs) - myocardial infarction (mi), who were performed balloon angioplasty and coronary artery stenting]. Arkhiv klinichnoi medytsyny, 25(1), 31-37. http://doi.org/10.21802/acm.2019.1.2 [in Ukrainian].
Koshelya, I. I. (2020). Epidemiolohiia infarktu miokarda v Ukraini [Epidemiology of myocardial infarction in Ukraine]. Zdorovia natsii, (3/1), 63-68. http://doi.org/10.24144/2077-6594.3.2.2020.213696 [in Ukrainian].
Ministry of Health of Ukraine. (2017, July 2). Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry hostromu koronarnomu syndromi z elevatsiieiu sehmenta ST [On Approval and implementation of the technological medical documents on standardizing the management of ST segment elevation acute coronary syndrome (No. 455)]. https://zakon.rada.gov.ua/rada/show/v0455282-14#Text
Shved, M., Tsuglevych, L., Kyrychok, I., Boiko, T., & Levutska, L. (2017). Kardioreabilitatsiia khvorykh na hostryi koronarnyi syndrom, yakym provedeno revaskuliaryzatsiiu koronarnykh arterii [Cardiorehabilitation of Patients with Acute Coronary Syndrome Who Were Performed Coronary Arteries Revascularization]. Halytskyi likarskyi visnyk, 24(4), 34-38. https://doi.org/10.21802/gmj.2017.4.9 [in Ukrainian].
Shved, M. I., & Levytska, L. V. (2018). Suchasni tekhnolohii vidnovnoho likuvannia khvorykh iz hostrym koronarnym syndromom [Modern technologies of rehabilitation treatment for patients with acute coronary syndrome]. Medknyha. [in Ukrainian].
Shved, M. I., Tsuglevich, L. V., Heryak, S. M., Kovbasa, N. M., Prokopovich, O. O., & Jastremska, I. O. (2019). Shliakhy pidvyshchennia efektyvnosti likuvannia ta profilaktyky reperfuziinoho syndromu u khvorykh na hostryi koronarnyi syndrom (infarkt miokarda), yakym provedeno balonnu anhioplastyku ta stentuvannia koronarnoi arterii [Ways for improvement of central and peripheral hemodynamics in patients with acute coronary syndrome (myocardial infarction), who underwent balloon angioplasty and stenting of the coronary artery]. Zdobutky klinichnoi i eksperymentalnoi medytsyny, (1), 173-181. http://doi.org/10.11603/1811-2471.2019.v0.i1.10071 [in Ukrainian].
Shehab, A., Bhagavathula, A. S., Alhabib, K. F., Ullah, A., Suwaidi, J. A., Almahmeed, W., AlFaleh, H., & Zubaid, M. (2020). Age-Related Sex Differences in Clinical Presentation, Management, and Outcomes in ST-Segment-Elevation Myocardial Infarction: Pooled Analysis of 15 532 Patients From 7 Arabian Gulf Registries. Journal of the American Heart Association, 9(4), Article e013880. https://doi.org/10.1161/JAHA.119.013880
Kander, M. C., Cui, Y., & Liu, Z. (2017). Gender difference in oxidative stress: a new look at the mechanisms for cardiovascular diseases. Journal of Cellular and Molecular Medicine, 21(5), 1024-1032. https://doi.org/10.1111/jcmm.13038
Madonna, R., Balistreri, C. R., De Rosa, S., Muscoli, S., Selvaggio, S., Selvaggio, G., Ferdinandy, P., & De Caterina, R. (2019). Impact of Sex Differences and Diabetes on Coronary Atherosclerosis and Ischemic Heart Disease. Journal of Clinical Medicine, 8(1), Article 98. https://doi.org/10.3390/jcm8010098
Kotseva, K., De Backer, G., De Bacquer, D., Rydén, L., Hoes, A., Grobbee, D., Maggioni, A., Marques-Vidal, P., Jennings, C., Abreu, A., Aguiar, C., Badariene, J., Bruthans, J., Castro Conde, A., Cifkova, R., Crowley, J., Davletov, K., Deckers, J., De Smedt, D., De Sutter, J., … EUROASPIRE Investigators*. (2019). Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry. European Journal of Preventive Cardiology, 26(8), 824-835. https://doi.org/10.1177/2047487318825350
Mehilli, J., & Presbitero, P. (2020). Coronary artery disease and acute coronary syndrome in women. Heart, 106(7), 487-492. https://doi.org/10.1136/heartjnl-2019-315555
Marwick, T. H., Gillebert, T. C., Aurigemma, G., Chirinos, J., Derumeaux, G., Galderisi, M., Gottdiener, J., Haluska, B., Ofili, E., Segers, P., Senior, R., Tapp, R. J., & Zamorano, J. L. (2015). Recommendations on the use of echocardiography in adult hypertension: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE). European Heart Journal - Cardiovascular Imaging, 16(6), 577-605. https://doi.org/10.1093/ehjci/jev076
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