Heart attack predictors different in men and women

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.