Razlika u smrtnosti između muškaraca i žena u akutnom infarktu miokarda

master's thesis

• Title (english): Mortality differences between men and women after acute myocardial infarction
• Author: Lovro Marinović
• Mentor: Diana Delić-Brkljačić (mentor)
• Committee member: Nikola Bulj (predsjednik povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Committee member: Diana Delić-Brkljačić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

UVOD: Akutni infarkt miokarda jedan je od glavnih uzroka smrti u razvijenim državama. Ranija istraživanja pokazala su da žene imaju veću smrtnost nakon preboljelog infarkta miokarda. Još uvijek nije jasno može li se ta razlika objasniti samo razlikom u prosječnoj dobi. ----- CILJ: Odrediti povezanost ženskog spola sa smrtnošću nakon akutnog infarkta miokarda tijekom razdoblja praćenja od 36 do 48 mjeseci. ----- ISPITANICI I METODE: Korišten je MIRCO (engl. Myocardial Infarction Registry of Comorbidities and Outcomes) registar pacijenata liječenih od akutnog infarkta miokarda u KBC Sestre milosrdnice. Za ovo istraživanje korišteni su podaci pacijenata iz 2015. godine. ----- REZULTATI: Među 451 pacijentom liječenim od akutnog infarkta miokarda bilo je 320 (71%) muškaraca i 131 (29%) žena. Prosječna dob muških pacijenata bila je 63, a ženskih pacijenata 73 godine. Muški pacijenti imali su višu učestalost hiperlipidemije i pušenja te viši prosječni indeks tjelesne mase. Ženski pacijenti su imali višu prosječnu koncentraciju glukoze u krvi (sve p<0.05). Preživljenje tijekom praćenja bilo je 85.0% za muške pacijente i 77.1% za ženske pacijente. Prema Kaplan-Meierovim krivuljama ženski pacijenti imali su značajno veću smrtnost od muških. Kad je metodom multivarijatne Coxove regresije uzeta u obzir viša prosječna dob ženskih pacijenata, razlika u smrtnosti više nije bila statistički značajna (HR=1.50 [0.92-2.45], p=0.104). ----- ZAKLJUČAK: Žene rjeđe obolijevaju od akutnog infarkta miokarda od muškaraca, ali nakon preboljelog infarkta miokarda, one imaju višu smrtnost. Ta razlika može se objasniti višom prosječnom dobi u kojoj žene dobivaju infarkt. Kako bi se bolje razumjela ta razlika, potrebno je napraviti veće i multicentrične studije.

Abstract (english)

BACKGROUND: Acute myocardial infarction is one of the most common causes of death in developed countries. Previous studies have shown that women experience higher mortality in the period following acute myocardial infarction. It is still not clear whether this is due to higher average age of female patients or due to other causes. ----- OBJECTIVE: To determine the association of female sex to mortality after acute myocardial infarction during 36-48 months of follow-up. ----- PATIENTS AND METHODS: This study used patient data from the MIRCO registry (Myocardial Infarction Registry of Comorbidities and Outcomes) of patients who were treated for acute myocardial infarction in University Hospital Centre Sestre milosrdnice. For this study we used patient data from the year 2015. ----- RESULTS: Among 451 patients with acute myocardial infarction, 320 (71%) were male and 131 (29%) were female. The average age of male and female patients was 63 and 73, respectively. Male patients were more likely to smoke, be overweight and have hyperlipidemia. Female patients had higher average glucose blood levels on admission (all p<0.05). The survival rate during follow-up was 85.0% for male patients and 77.1% for female patients. Kaplan-Meier curves showed that female patients had significantly higher mortality than male patients. However, after using multivariate Cox regression to account for the higher average age of women, the difference became statistically insignificant (HR=1.50 [0.92-2.45], p=0.104). ----- CONCLUSION: Women have a lower incidence of acute myocardial infarction than men. However, in the following years they have a significantly higher mortality rate. This difference can be explained by the higher average age of female patients. To further study this difference, larger and multicentric studies should be done.

• Keywords: akutni infarkt miokarda; mortalitet; spolne razlike
• Keywords (english): acute myocardial infarction; sex differences; mortality
• Language: croatian
• URN:NBN: urn:nbn:hr:105:223376
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-11 09:28:27