Sex-Related Differences in Outcomes for Patients With ST Elevation Myocardial Infarction (STEMI): A Tamil Nadu-STEMI
Thomas Alexander1, Suma M Victor2, Balakumaran Jayakumaran1
1Kovai Medical Centre Hospital, Coimbatore, Tamil Nadu, India.
Heart, Lung & Circulation
|June 5, 2021
Summary
Women with ST elevation myocardial infarction (STEMI) present later and have worse outcomes than men. This study highlights the increased mortality risk for females experiencing STEMI, emphasizing a critical need for targeted care.
Area of Science:
- Cardiology
- Public Health
- Sex Differences in Medicine
Background:
- ST elevation myocardial infarction (STEMI) is a significant cause of coronary artery disease presentation in India.
- Women with STEMI often face higher risks of adverse outcomes compared to men due to various contributing factors.
- Understanding sex-based disparities in STEMI is crucial for improving patient care and outcomes.
Purpose of the Study:
- To investigate and compare the clinical characteristics and prognosis of male and female patients diagnosed with STEMI.
- To identify sex-related differences in STEMI presentation, management, and outcomes within a healthcare system.
- To evaluate the impact of sex on short-term and long-term mortality in STEMI patients.
Main Methods:
- Subgroup analysis of the prospective, observational Tamil Nadu-STEMI (TN-STEMI) program.
- Inclusion of 2,420 patients with STEMI from four hub-and-spoke clusters in Tamil Nadu, India, between 2012 and 2014.
- Data combined from pre- and post-integrated STEMI system implementation, with a 1-year follow-up period.
Main Results:
- Female patients presented later (mean age 60.1 years vs. 53.7 years) and had higher prevalence of diabetes and hypertension.
- Symptom onset to first medical contact was delayed in women (193 mins vs. 170 mins).
- Women experienced significantly higher in-hospital (10.4% vs. 4.8%) and 1-year mortality (26.7% vs. 13%), persisting even in younger populations (<45 years).
Conclusions:
- Women with STEMI exhibit an unfavorable risk profile compared to men.
- Adverse short-term and long-term prognoses are observed in female STEMI patients.
- Adjusted regression analysis indicated an increased likelihood of mortality in females (1.8 times).
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
24.4K
09:21Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
12.3K
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
204
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
204
01:30Acute Coronary Syndrome III: Diagnostic Studies
59
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
59
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
102
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
102
01:20Angina V: Nursing Management
112
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
112
01:14Myocarditis III: Medical Management
43
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
43
01:17Ischemic Heart Disease: Overview
2.2K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
2.2K