Detection and significance of myocardial ischemia in women versus men within six months of acute myocardial infarction or unstable angina. The Multicenter Myocardial Ischemia Research Group.
Detection and significance of myocardial ischemia in women versus men within six months of acute myocardial infarction or unstable angina. The Multicenter Myocardial Ischemia Research Group.
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急性心肌梗塞或不稳定心绞痛六个月内女性与男性心肌缺血的检测和意义。
DOI：
10.1016/s0002-9149(97)89172-2
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Mass,AJ
中科院分区：
文献类型：
--
作者：
Moriel,M;Benhorin,J;Brown,MW;Raubertas,RF;Severski,PK;VanVoohees,L;Bodenheimer,MM;Tzivoni,D;Wackers,FJ;Mass,AJ
急性冠状动脉事件后的缺血检测可预测随后的心脏事件。然而，急性冠状动脉事件后缺血检测的患病率和预后意义的性别相关方面尚未报道。对936例稳定患者（224例女性和712例男性）在急性冠状动脉事件（即，心肌梗塞或不稳定型心绞痛）。平均随访23个月的主要终点包括心源性死亡、非致死性心肌梗死和不稳定型心绞痛，而限制性终点包括前2个。在24小时动态心电图、运动心电图和铊-201负荷心电图中，女性缺血检测的频率明显低于男性。主要终点发生在19.2%的女性和19%的男性中，限制性终点发生在5.8%的女性和8%的男性中（p = NS）。考克斯分析显示，性别及其与每项缺血试验的相互作用对主要或限制性终点的预测没有贡献。我们的结论是，在急性冠状动脉事件后1至6个月的稳定患者中，女性无创性检查的缺血检测率明显低于男性。然而，女性随后的心脏事件发生率与男性相似，并且关于随后的事件，性别-缺血检测没有相互作用。
Ischemia detection after an acute coronary event predicts subsequent cardiac events. However, gender-related aspects in the prevalence and prognostic significance of ischemia detection after an acute coronary event have not been reported. Noninvasive tests, which included resting 12-lead electrocardiogram (ECG), 24-hour ambulatory ECG, exercise ECG, and thallium-201 stress scintigraphy were performed in 936 stable patients (224 women and 712 men) 1 to 6 months (average 2.7) after an acute coronary event (i.e., myocardial infarction or unstable angina). Primary end points during an average follow-up of 23 months included cardiac death, nonfatal myocardial infarction, and unstable angina, while restricted end points included the first 2. Ischemia detection was significantly less frequent among women than among men on 24-hour ambulatory ECG, exercise ECG, and thallium-201 stress scinrigraphy. Primary end points occurred in 19.2% of women and in 19% of men, and restricted end points occurred in 5.8% of women versus 8% of men (p = NS). Cox analyses revealed that gender and its interaction with each of the ischemia tests did not contribute to the prediction of the primary or restricted end points. We conclude that in stable patients 1 to 6 months after an acute coronary event, ischemia detection by noninvasive tests was significantly less prevalent in women than in men. However, subsequent cardiac event rates in women were similar to those observed in men, and there was no gender-ischemia detection interaction regarding subsequent events.