The aim of the research is to study clinical, hemodynamic, affective disorders in ST-segment elevation acute coronary syndrome (STEACS); to identify gender risk factors affecting the outcomes. Material and methods. The study included 90 males and 90 females with ST-segment elevation acute coronary syndrome. All patients underwent echocardiography, coronary angiography (CAG), and a set of laboratory examinations. Spielberger test, CES-D scales, Morisky-Green test, and Montreal Cognitive Function Scale were uses to study psycho-emotional status of 75 males and females. The treatment was carried out in accordance with current clinical protocols, clinical guidelines and standards. The prognosis was assessed in a year. The results were processed using nonparametric statistics methods. Results. It was revealed that the females, included in the study, were older than males; they more often suffered from coronary artery disease, hypertension, type 2 diabetes, constitutive obesity (before the index event); they more regularly underwent antihypertensive therapy; they more often reached target BP values. There were no differences in features of coronary anatomy, frequency of invasive treatment, but females were significantly more likely to undergo thrombolytic therapy. Males smoked more often; asked for medical help earlier from the onset of anginal syndrome; they were more susceptible to dilatation of the left ventricular cavity. Females more often than males had high and medium level of personal anxiety, as well as high level of situational anxiety. Predictors of worsening prognosis in females are 4-vascular lesion of coronary bed, cardiogenic shock upon admission, decreased hemoglobin, dilatation of the left atrium, decreased cognitive functions, smoking. In males the predictors are: 3-vascular damage, cardiogenic shock, renal failure. Conclusion. It was found that in STEACS there are differences between males and females in several clinical, anatomical and functional characteristics. Risk factors for an unfavorable prognosis are gender specific. The revealed facts can be useful in individualized treatment, rehabilitation and secondary prevention programs.
Gender features of clinical course and outcomes of acute coronary syndrome with segment rise