The aim to study and compare the results of pharmacological reperfusion and its influence on the course of acute coronary syndrome (ACS) in both sexes.
Materials and Methods
The study included 73 patients of comparable age, comorbidities, a history and treatment assigned and distributed the following groups: group I (n = 14 men, n = 14 women) - patients who conducted thrombolytic therapy to 4 hours from the beginning of symptoms and the group II (n = 20 males, n = 20 women) - patients who conducted thrombolytic therapy in term> 4 <6 hours from the start of the first symptom. After thrombolytic therapy for hospital period it was evaluated in patients develop fatal and non-fatal cardiovascular events: recurrence of pain, acute left ventricular failure (ALVF) class II-V by Killip, arrhythmias and conduction recurrence of MI, hemorrhage, mortality. The development of these events in patients regarded as a manifestation of adverse flow.
Thrombolytic therapy (TLT) <4 hours of the first symptoms accompanied by an increased risk of bleeding is 5 times among women compared with men. Among men in the group of early TLT lethal consequence developed in 4 (22.6%), while among women had no place (all p <0.05). Gender differences were detected in the remote TLT group (> 4 <6 hours). Among women group I (TLT (<4 hours) compared with women group II (TLT> 4 <6 hours) was noted increase in the frequency of re-MI (p <0.05) and mortality (p <0,01).
1. Implementation of TLT in up to 4 hours of onset of symptoms of ACS with ST-segment elevation is associated with increased risk of bleeding is 5 times among women compared with men (p <0.05). Death among men was significantly higher than in women whith early pharmacological reperfusion (<4 hours), and occurred in 28.6% (p <0.05).
2. The risk of complications such as MI recurrence (p <0.05) and mortality (p <0,01) increased with time from onset of symptoms to start of thrombolysis only among women.
3. The effectiveness of thrombolysis among women and men with early (<4 hours) and remote thrombolytic therapy (> 4 <6 hours) were not significantly different.
Keywords: women, reperfusion, thrombolysis, myocardial infarction.
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