RESUMO
To compare the presentation [symptoms and signs], treatment and outcome of men and women with Acute Myocardial Infarction [AMI]. A prospective observational study. Accident and Emergency Department and Medical Department of a tertiary core hospital. Consecutive patients [total 272: 172 men and 100 women] presenting with Acute Myocardial Infarction [AMI]. Interventions: No intervention for the purpose of this study. Main outcome measures: Differences between men and women in presentation, hospital course, prognostic factors, therapeutic strategies, complications and outcome after AMI. Women presented later after start of chest pain, complained of dyspnoea more frequently and more commonly suffered from non-Q AMI than men. Other symptoms and haemodynamic and electrocardiographic findings were for the most part similar in both sexes. Women were older than men [63.84 vs. 59.25 years, p=0.029] and had higher prevalence of diabetes, hypertension and congestive cardiac failure. Women were almost one third as likely to undergo any intervention [thrombolysis, coronary angioplasty or coronary bypass surgery] during acute phase of AMI [odds ratio 0.3 [0.2 to 0.4]]. Thirty days mortality after AMI was higher in women than men [odds ratio 2.05 [0.8 to 5.2]]. Other independent predictors of mortality at 30 days after AMI included older age, low blood pressure and higher heart rate at presentation and presence of diabetes mellitus. Acute myocardial infarction is not as aggressively treated in women as in men. Outcome in women is also less favourable than in men. Other nongender-specific risk factors are also important as prognostic indicators and as indicators of early intervention after AMI