Aim To identify predictors of adverse course and cardiovascular mortality during hospital period of acute myocardial infarction among female patients.
Materials and Methods. The study included 65 women with myocardial infarction (MI) with elevation segment ST. In order to find predictors of unfavorable development of MI combined end point (CEP) (acute left ventricular failure class III-IV and recurrence by T.Killip MI) and cardiovascular mortality was promoted single-factor analysis, options which were identified fairly significant, used in multivariate stepwise discriminant analysis with determination of the odds ratio (OR).
Results. Risk of CET increased in women with MI and presence of following indicators of progress plasma coagulation hemostasis the concentration of soluble complexes fibrynmonomers > 4x10 g / l (OR 4.1), reduction of protein C normalized ratio <0.72 (OR 3.7 ), the duration activated partial thromboplastin time <50 c (3.0 HS) and thrombin time <22s (OR 4.4). The most influential parameter functional activity of platelets appeared extent of platelet aggregation induced by arachidonic acid> 3.3% (OR 5.1) and adenosine diphosphate> 4.1% (OR 2.2). Microalbuminuria (MAU) with albumin-creatynin ratio (ACR) from 3 to 30 mg / mol in 6 times increased risk of CEP (OR 6.6). In the course of development of complications of MI and impact indicators such as coronary artery disease duration <3 years (OR 1.8) and hypertension> 5 years (OR 1.6)). An adverse effect on course of MI had a duration of postmenopausal period (<5 years), which is up to 3.9 times increased the likelihood of CEP MI and cardiovascular mortality up to 7.1 times (p <0.05).
Conclusion: The results of indicators plasma coagulation and platelet hemostasis, MAU definition with ACR and a history, especially the duration of postmenopausal period have prognostic value and should be used to differentiate women with MI risk stratification for.
Key words: myocardial infarction, predictors, weather, woman.
- Neufeld IV, Bobylev IV, Skupova JH [Risk factors for heart disease in postmenopausal women according to body mass index]. Bulletin of Medical Internet Conferences. 2012;
- Jackson E.A., Moscucci M., Smith D.E., Share D., Dixon S., Greenbaum A., Gurm H.S. The association of sex with outcomes among patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction in the contemporary era: Insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2).American heart journal. 2011;161(1):106-112.
- ShufeltMerz C. N. B. Female-Specific Factors for IHD: Across the Reproductive Lifespan.Curr Atheroscler Rep.2015;17(2):481.
- Maas A.H.,van der Schouw Y.T.,Regitz-Zagrosek V.,Swahn E.,Appelman Y.E.,Pasterkamp G.,Ten Cate H.,Nilsson P.M.,Huisman M.V.,Stam H.C.,Eizema K., Stramba-Badiale M. Red alert for women’s hearts: The urgent need for more research and knowledge on cardiovascular disease in women. Proceedings of the workshop held in Brussels on ‘Gender Differences on Cardio- vascular Disease’. EurHeartJ.2011 Jun;32(11):1362-8.
- Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)1, Steg P.G., James S.K., Atar D., Badano L.P., Blömstrom-Lundqvist C., Borger M.A., Di Mario C., Dickstein K., Ducrocq G., Fernandez-Aviles F., Gershlick A.H., Giannuzzi P., Halvorsen S., Huber K., Juni P., Kastrati A., Knuuti J., Lenzen M.J., Mahaffey K.W., Valgimigli M., van 't Hof A., Widimsky P., Zahger D. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. 2012 ;33(20):2569-619.
- Harrison P.,Mackie I.,Mumford A.,Briggs C.,Liesner R.,Winter M.,Machin S.;British Committee for Standards in Haematology.. Guidelines for the laboratory investigation of heritable disorders of platelet function. British journal of haematology. 2011; 155 (1): 30-44.
- Inker L.A.,Astor B.C.,Fox C.H.,Isakova T.,Lash J.P.,Peralta C.A.,Kurella Tamura M.,Feldman H.I.. Inker L.A. et al. KDOQI US Commentary on the 2012 KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD.American Journal of Kidney Diseases. 2014 May;63(5):713-35.
- Chen Y.,Zeleniuch-Jacquotte A.,Arslan A.A.,Wojcik O.,Toniolo P.,Shore R.E.,Levitz M.,Koenig K.L. Endogenous hormones and coronary heart disease in postmenopausal women 2011;216(2):414-9.
- Yahagi K., Harry R. Davis, Arbustini E. et al. Sex differences in coronary artery disease: Pathological observations. Atherosclerosis.2015; Vol. 239.:260-267.