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Epidemiological Profile for Acute Coronary Syndrome: The Difference between Genders in an Intensive Care Unit

Abstract

Vargas LA, Boin AC, Santiago RAB and Correa FG

Background: Acute Myocardial Infarction (ACS), a complication of acute coronary syndrome is a major cause of death in industrialized countries. The incidence of these diseases has increased, but the rate of mortality among patients decreased over the years.The mortality of acute myocardial infarction is higher in men than women, but for female coronary disease is most fatal in relation to the other sex.

Methods: The data was collected between October 2003 and December 2010 from patients who were admitted in the Intensive Care Unit of Hospital Santa Lucia, a private institution in Brasilia-DF, Brazil with the diagnosis of ACS. For the study of in-hospital mortality, we calculated the mortality rate of the years studied and Spearman bivariate correlation was used to determine the level of significance of the values found. By means of the nonparametric Kruskal- Wallis sought to find a statistically significant relationship between deaths per year.Factors with possible influence were analyzed by logistic regression models and were associated as covariates.Statistical analysis was performed using SPSS 20.0 software.

Results: Altogether, 1005 were analyzed from a large database.There was a reduction in the rate of mortality from acute coronary syndromes over the years evaluated, the Spearman bivariate correlation found a significant relationship (p = - 0.059). The highest percentage of deaths was found in 2008 (17.6%), the lowest in 2009 (3.8%). Of the total sample 32.32% were women. The mortality rate of ACS among women (11.8%) was almost double compared with the male sex (7.1%), the bivariate correlation has shown statistically significant (p = 0.078). In logistic regression models the relationship between gender and death has changed in the female gender with age (p = 0.013) and presence of family history (p = 0.018), in the male gender with age (p = 0.017). The others co-variables showed no statistically significant relationship with mortality between genders.

Conclusion: This study showed a statistically significant reduction in hospital mortality from acute coronary syndrome between 2003 and 2010. Our findings indicate that the mortality is higher in women than in men after an episode of acute coronary syndrome. The risk factors such as age and family history are important because their presence influences the mortality of each case.