Gender Difference Found in Heart Attack Predictors

The predictors of myocardial infarction (MI) before hospital admission differ between men and women among patients with suspected acute coronary syndrome, according to a new study.

Researchers from Sahlgrenska University Hospital (Goteborg, Sweden) conducted a prospective observational study involving 433 patients (45% of them women) who were transported to the hospital by ambulance with a suspected acute coronary syndrome without ST-elevation. The ambulance crew assessed the patients, obtained a short history, and conducted a basic examination that included measurements of blood pressure and heart rate. The ambulances were equipped to record an electrocardiogram (ECG) that could be transmitted to the hospital. The paramedics also measured myoglobin, creatine kinase (CK)-MB, and troponin-I.

Women tended to be older than men and had a lower prevalence of a previous acute MI. Ultimately, it turned out that 17% of women and 26% of men developed acute MI. Among patients with initial ST-depression, 22% of women and 54% of men developed acute MI. The investigators observed a significant interaction between gender and the influence of ST-depression on the risk for development of MI. The results were published in the May 2006 issue of the International Journal of Cardiology.

Overall, among women a previous history of acute MI and advanced age were independent predictors for the development of acute MI. Among men the following were independent predictors: presence of ST-depression and Q-waves, and elevation of any biochemical marker prior to hospital admission.



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