Vol. 6, Issue 2, Part B (2024)

Introduction: Cardiovascular disease involves men more frequently than women. However, women with acute myocardial infarction (AMI) are more likely to die of the disease than men. The reasons for this mortality difference are not completely understood and the method to predict excess mortality in women is still lacking.

Objectives: To compare the in-hospital outcome between male and female patients with acute myocardial infarction.

Methodology: This cross-sectional observational study was conducted in the Department of Cardiology Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from July 2014 to June 2016. Fifty female (group-A) and 50 male (group-B) patients with definite diagnosis of acute myocardial infarction admitted within 24 hours of symptom onset, received Streptokinase (in cases of ST elevation myocardial infarction), aged above 18 years and both sex were included. Prior myocardial infarction, cardiomyopathy, valvular heart disease, Previous MI with revascularization and those who were not willing to enroll in this study were excluded.

Results: Females were older [60.28 (SD 9.50) versus 50.26 (SD 8.88) years; p<0.001], more frequently had diabetes mellitus (50.0% versus 30.0%; p<0.05), dyslipidaemia (58.0% versus 38.0%; p<0.05), Killip class (III and IV) (32.0% versus 14.0%; p<0.05, greater pre-hospital delay of more than 12 hours (46.0% versus 18.0%; p<0.01), higher in-hospital mortality (24.0% versus 6.0%; p<0.05), acute left ventricular failure [16 (32.0%) versus 7 (14.0%); p<0.05] and cardiogenic shock [6 (12.0%) versus 1 (2.0%); p<0.05] were significantly more in female than that of male. On the other hand female were less frequent smoker (6.0% versus 68.0%; p<0.001). Whereas hypertension (56.0% versus 42.0%; p>0.05), ST elevation MI (86.0% and 84.0%; p>0.05), anterior acute myocardial infarction (52.2% and 52.4%; p>0.05), use of streptokinase (70.0% versus 74.0%; p> 0.05), ventricular tachycardia [2 (4.0%) versus 0 (0.0%); p>0.05]; ventricular fibrillation [1 (2.0%) versus 0 (0.0%); p>0.05]; atrioventricular block [6 (12.0%) versus 5 (10.0%); p>0.05], post mi angina [3 (6.0%) versus 2 (4.0%); p>0.05] and re-infarction [3 (6.0%) versus 1 (2.0%); p>0.05] did not differ significantly between female and male. Female sex [OR=4.95; (95% CI=1.30-18.81; p<0.05), diabetes mellitus [OR=5.05; (95% CI=1.16-22.00; p<0.05) and Killip class III and IV [OR=6.38; (95% CI=1.69-24.10; p<0.01) were independent predictors of mortality.

Conclusion: It may be concluded from the present study that hospital outcomes are worse in female than that of male in acute myocardial infarction.