Heart attack predictors different in men and women

NEW YORK (Reuters Health) – Among patients having symptoms
of a heart attack, the predictors detected before hospital
admission differ between men and women, according to results of
a study by investigators in Sweden, published in the
International Journal of Cardiology.

Dr. Johan Herlitz, of Sahlgrenska University Hospital,
Goteborg, and colleagues conducted a study involving 433
patients (45 percent women) who were transported to the
hospital by ambulance with a suspected heart attack.

The ambulance crew assessed the patients, obtained a short
history, and conducted a basic examination that included
measurements of blood pressure and heart rate. The ambulances
were equipped to record an electrocardiogram (ECG) that could
be transmitted to the hospital. The ECG assesses the electrical
activity of the heart, as well as irregularities and muscle
damage. The paramedics also took blood sampled to look for
biomarkers that indicate a heart attack has occurred.

The female patients tended to be older than the male
patients and they also had a lower prevalence of a previous
heart attack. Ultimately, it turned out that 17 percent of the
women and 26 percent of the men had a diagnosis of heart
attack.

Among patients with initial ST-depression, an abnormal drop
the ECG reading, 22 percent of women and 54 percent of men were
diagnosed with a heart attack. The investigators observed a
significant interaction between gender and the influence of
ST-depression associated with heart attack risk.

Among women, a previous heart attack and an older age were
the major predictive factors, Herlitz and colleagues report.
Among men, the predictors included ST-depression and Q-waves on
ECG and the elevation of any biochemical marker before hospital
admission.

The team concludes that the patient features that indicate
heart damage may not be completely the same for men and women.

SOURCE: International Journal of Cardiology, May 2006.