Relevância em distinções na conduta da síndrome coronariana aguda no sexo feminino
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Sep 30, 2023
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Resumo
Objetivo: Verificar a existência de diferenças no diagnóstico, tratamento e mortalidade da Síndrome Coronariana Aguda em pessoas do sexo feminino. Métodos: Revisão integrativa realizada no período de janeiro a março de 2023, considerando artigos publicados entre 2018 e 2023, em português, inglês e espanhol. Foram consultadas as bases de dados Medline, Lilacs e IBECS. Dos 128 artigos encontrados, 26 foram considerados adequados para compor esta revisão. Resultados: Na Síndrome Coronariana Aguda (SCA) há disparidade, de acordo com o sexo, na manifestação dos sintomas, realização do primeiro eletrocardiograma e uso de tratamento invasivo. Além disso, fatores estressantes, depressão, status socioeconômico, gestação e fatores hormonais alteram o perfil clínico e o tempo de intervenção, bem como, podem levar ao atraso na busca pelo atendimento. Considerações finais: Considera-se que a SCA, em mulheres, apresenta diferenças de incidência, evolução e desfecho em relação aos homens, com pior prognóstico no sexo feminino. Assim, há necessidade de conscientização e prevenção cardiovascular, para minimizar as complicações e melhorar o desfecho clínico.
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Como Citar
PinheiroI. C. M., TeixeiraE. C., SilvaA. K. das N. S., FernandesC. D., NascimentoE. C. A., NascimentoM. E. S., PaulaG. de, VilhenaG. K. S., & QuartiM. L. M. (2023). Relevância em distinções na conduta da síndrome coronariana aguda no sexo feminino. Revista Eletrônica Acervo Saúde, 23(9), e13851. https://doi.org/10.25248/reas.e13851.2023
Seção
Revisão Bibliográfica
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Referências
1. ALLANA S, et al. Sex differences in symptoms experienced, knowledge about symptoms, symptom attribution, and perceived urgency for treatment seeking among acute coronary syndrome patients in Karachi Pakistan. Heart Lung, 2018; 47(6): 584-590.
2. ALYASIN N, et al. The experience of women following first acute coronary syndrome: An integrative literature review. Journal of advanced nursing, 2021; 77(5): 2228-2247.
3. BECKOWSKI M, et al. Differences in symptomatology and clinical course of acute coronary syndromes in women ≤ 45 years of age compared to older women. Current problems in cardiology, 2021; 46(3): 100508.
4. BUGIARDINI R, et al. Female sex as a biological variable: A review on younger patients with acute coronary syndrome. Trends in cardiovascular medicine, 2019; 29(1): 50-55.
5. CARDOSO MR, et al. Correlação entre a complexidade das lesões coronarianas e os níveis de Troponina ultrassensível em pacientes com Síndrome Coronariana Aguda/ Correlation between the complexity of coronary lesions and high-sensitivity Troponin levels in patients with Acute Coronary Syndrome. International Journal of Cardiovascular Sciences, 2018; 31(3): 218-225.
6. CHOU LP, et al. Women were noninferior to men in cardiovascular outcomes among patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention from Taiwan acute coronary syndrome full-spectrum registry. Medicine (Baltimore), 2018; 97(43): e12998.
7. CORRAL MP, et al. Inequidades en la atención al dolor torácico de origen isquémico en Urgencias desde una perspectiva de género/ Inequality in the management of ischemic chest pain in the emergency department from a gender perspective. Revista española de salud pública, 2019; 93: 0-0.
8. COSTELLO BT e YOUNIS GA. Acute Coronary Syndrome in Women: An Overview. Texas Heart Institute Journal, 2020; 47(2): 128-129.
9. DAVIES RE e RIER JD. Gender Disparities in CAD: Women and Ischemic Heart Disease. Current atherosclerosis reports, 2018; 20(10): 51.
10. DEVON HA, et al. Typical and Atypical Symptoms of Acute Coronary Syndrome: Time to Retire the Terms?. Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, 2020; 9(7): e015539.
11. ESPUNY MP, et al. Influencia del género y el lugar de residencia sobre la evolución y mortalidad de la cardiopatía isquémica en Cataluña: un estudio de base poblacional/ Influence of gender and place of residence differences on the evolution and mortality of ischemic cardiopathy in Catalonia: a population-based study. Revista española de salud pública, 2023; 97: e202301004-e202301004.
12. EURIPEDES LV. Perfil clínico e epidemiológico da intervenção coronária percutânea em mulheres na última década/ Clinical and epidemiological profile of percutaneous coronary intervention in women in the last decade - Arquivi Brasileiro de Cardiologia, 2021; 117(2 supl. 1): 17-17.
13. GAFFEY AE, et al. Screening for Psychological Distress and Risk of Cardiovascular Disease and Related Mortality: A Systematized Review, meta-Analysis, and Case for Prevention. Journal of cardiopulmonary rehabilitation and prevention, 2022; 42(6): 404-415.
14. KNIGHT EP, et al. Communicating acute coronary syndrome risk to women in primary care: A scoping review of the literature. Patient education and counseling, 2019; 102(12): 2156-2161.
15. LANGABEER JR, et al. Gender-based outcome differences for emergency department presentation ofnon-STEMI acute coronary syndrome. American Journal of Emergency Medicine, 2019; 37(2): 179-182.
16. LEOCÁDIO P, et al. Níveis Elevados de Netrina-1 e IL-1β em Mulheres Idosas com SCA: Pior Prognóstico no Acompanhamento de Dois Anos / High Serum Netrin-1 and IL-1β in Elderly Females with ACS: Worse Prognosis in 2-years Follow-up. Arquivo Brasileiro de Cardiologia, 2020; 114(3): 507-514.
17. LOURDES V e MARTÍNEZ-SELLÉZ M. Frailty and acute coronary syndrome: does gender matter?. Journal of geriatric cardiology, 2019; 16(2): 138-144, 2019.
18. MACKAY MH, et al. Racism Is Not a Factor in Door-to-electrocardiogram Times of Patients With Symptoms of Acute Coronary Syndrome: A Prospective, Observational Study. Academic emergency medicine, 2019; 26(5): 491-500.
19. MAOR E, et al. Sex Disparities in First Medical Contact of Patients with Suspected Acute Coronary Syndrome Using Telemedicine Technology. Telemedicine journal and e-health, 2020; 26(4): 411-418.
20. MATETIC A, et al. Trends of Sex Differences in Clinical Outcomes After Myocardial Infarction in the United States. Canadian Journal of Cardiology, 2021; 3(12 Suppl): S19-S27.
21. MEHILLI J e PRESBITERO P. Coronary artery disease and acute coronary syndrome in women. Heart, 2020; 106(7): 487-492.
22. MIRZAEI S, et al. The association between symptom onset characteristics and prehospital delay in women and men with acute coronary syndrome. European Journal of Cardiovascular Nursing, 2020; 19(2): 142-154.
23. PÉREZ-CUEVAS R, et al. Gaps between supply and demand of acute myocardial infarction treatment in Mexico/ Brechas entre la oferta y la demanda del tratamiento de infarto agudo al miocardio en México. Salud pública de México, 2020; 62(5): 540-549.
24. PINTO MGCS, et al. Mulher jovem com IAM: é tempo de pensarmos além dos fatores de risco cardiovascular convencionais/ Young woman with AMI: time to think beyond conventional cardiovascular risk factors. Arquivo Brasileiro de Cardiologia, 2019; 113(2 supl.1): 87-87.
25. SAMUEL R, et al. Coronary Events in the Pregnant Patient: Who Is at Risk and How Best to Manage?. Canadian Journal of Cardiology, 2021; 37(12): 2026-2034.
26. SCHMIDT K, et al. Stress in Women with Acute Myocardial Infarction: A Closer Look/ Um Olhar sobre o Stress nas Mulheres com Infarto Agudo do Miocárdio. Arquivo Brasileiro de Cardiologia, 2020; 115(4): 649-657.
27. SÖRENSEN NA, et al. Relations of Sex to Diagnosis and Outcomes in Acute Coronary Syndrome. Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, 2018; 7(6).
28. STEHLI J, et al. Sex Differences Persist in Time to Presentation, Revascularization, and Mortality in Myocardial Infarction Treated With Percutaneous Coronary Intervention. Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, 2019; 8(10): e012161.
29. TIZÓN-MARCOS H, et al. Socioeconomic Status and Prognosis of Patients With ST-Elevation Myocardial Infarction Managed by the Emergency-Intervention “Codi IAM” Network. Frontiers in Cardiovascular Medicine, 2022; 9: 847982.
30. VALLABHAJOSYULA S, et al. Sex Disparities in the Use and Outcomes of Temporary Mechanical Circulatory Support for Acute Myocardial Infarction-Cardiogenic Shock. Canadian Journal of Cardiology, 2020; 2(6): 462-472.
31. VAN DER MEER MG, et al. Are there gender disparities in symptom presentation or triage of patients with chest discomfort at primary care out-of-hours services? An observational study. - BMJ Open, 2019; 9(11): e031613.
32. ZOU Y, et al. Sex differences in the management and clinical outcome among patients with acute coronary syndrome. BioMed Central cardiovascular disorders (Online), 2021; 21(1): 609.
2. ALYASIN N, et al. The experience of women following first acute coronary syndrome: An integrative literature review. Journal of advanced nursing, 2021; 77(5): 2228-2247.
3. BECKOWSKI M, et al. Differences in symptomatology and clinical course of acute coronary syndromes in women ≤ 45 years of age compared to older women. Current problems in cardiology, 2021; 46(3): 100508.
4. BUGIARDINI R, et al. Female sex as a biological variable: A review on younger patients with acute coronary syndrome. Trends in cardiovascular medicine, 2019; 29(1): 50-55.
5. CARDOSO MR, et al. Correlação entre a complexidade das lesões coronarianas e os níveis de Troponina ultrassensível em pacientes com Síndrome Coronariana Aguda/ Correlation between the complexity of coronary lesions and high-sensitivity Troponin levels in patients with Acute Coronary Syndrome. International Journal of Cardiovascular Sciences, 2018; 31(3): 218-225.
6. CHOU LP, et al. Women were noninferior to men in cardiovascular outcomes among patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention from Taiwan acute coronary syndrome full-spectrum registry. Medicine (Baltimore), 2018; 97(43): e12998.
7. CORRAL MP, et al. Inequidades en la atención al dolor torácico de origen isquémico en Urgencias desde una perspectiva de género/ Inequality in the management of ischemic chest pain in the emergency department from a gender perspective. Revista española de salud pública, 2019; 93: 0-0.
8. COSTELLO BT e YOUNIS GA. Acute Coronary Syndrome in Women: An Overview. Texas Heart Institute Journal, 2020; 47(2): 128-129.
9. DAVIES RE e RIER JD. Gender Disparities in CAD: Women and Ischemic Heart Disease. Current atherosclerosis reports, 2018; 20(10): 51.
10. DEVON HA, et al. Typical and Atypical Symptoms of Acute Coronary Syndrome: Time to Retire the Terms?. Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, 2020; 9(7): e015539.
11. ESPUNY MP, et al. Influencia del género y el lugar de residencia sobre la evolución y mortalidad de la cardiopatía isquémica en Cataluña: un estudio de base poblacional/ Influence of gender and place of residence differences on the evolution and mortality of ischemic cardiopathy in Catalonia: a population-based study. Revista española de salud pública, 2023; 97: e202301004-e202301004.
12. EURIPEDES LV. Perfil clínico e epidemiológico da intervenção coronária percutânea em mulheres na última década/ Clinical and epidemiological profile of percutaneous coronary intervention in women in the last decade - Arquivi Brasileiro de Cardiologia, 2021; 117(2 supl. 1): 17-17.
13. GAFFEY AE, et al. Screening for Psychological Distress and Risk of Cardiovascular Disease and Related Mortality: A Systematized Review, meta-Analysis, and Case for Prevention. Journal of cardiopulmonary rehabilitation and prevention, 2022; 42(6): 404-415.
14. KNIGHT EP, et al. Communicating acute coronary syndrome risk to women in primary care: A scoping review of the literature. Patient education and counseling, 2019; 102(12): 2156-2161.
15. LANGABEER JR, et al. Gender-based outcome differences for emergency department presentation ofnon-STEMI acute coronary syndrome. American Journal of Emergency Medicine, 2019; 37(2): 179-182.
16. LEOCÁDIO P, et al. Níveis Elevados de Netrina-1 e IL-1β em Mulheres Idosas com SCA: Pior Prognóstico no Acompanhamento de Dois Anos / High Serum Netrin-1 and IL-1β in Elderly Females with ACS: Worse Prognosis in 2-years Follow-up. Arquivo Brasileiro de Cardiologia, 2020; 114(3): 507-514.
17. LOURDES V e MARTÍNEZ-SELLÉZ M. Frailty and acute coronary syndrome: does gender matter?. Journal of geriatric cardiology, 2019; 16(2): 138-144, 2019.
18. MACKAY MH, et al. Racism Is Not a Factor in Door-to-electrocardiogram Times of Patients With Symptoms of Acute Coronary Syndrome: A Prospective, Observational Study. Academic emergency medicine, 2019; 26(5): 491-500.
19. MAOR E, et al. Sex Disparities in First Medical Contact of Patients with Suspected Acute Coronary Syndrome Using Telemedicine Technology. Telemedicine journal and e-health, 2020; 26(4): 411-418.
20. MATETIC A, et al. Trends of Sex Differences in Clinical Outcomes After Myocardial Infarction in the United States. Canadian Journal of Cardiology, 2021; 3(12 Suppl): S19-S27.
21. MEHILLI J e PRESBITERO P. Coronary artery disease and acute coronary syndrome in women. Heart, 2020; 106(7): 487-492.
22. MIRZAEI S, et al. The association between symptom onset characteristics and prehospital delay in women and men with acute coronary syndrome. European Journal of Cardiovascular Nursing, 2020; 19(2): 142-154.
23. PÉREZ-CUEVAS R, et al. Gaps between supply and demand of acute myocardial infarction treatment in Mexico/ Brechas entre la oferta y la demanda del tratamiento de infarto agudo al miocardio en México. Salud pública de México, 2020; 62(5): 540-549.
24. PINTO MGCS, et al. Mulher jovem com IAM: é tempo de pensarmos além dos fatores de risco cardiovascular convencionais/ Young woman with AMI: time to think beyond conventional cardiovascular risk factors. Arquivo Brasileiro de Cardiologia, 2019; 113(2 supl.1): 87-87.
25. SAMUEL R, et al. Coronary Events in the Pregnant Patient: Who Is at Risk and How Best to Manage?. Canadian Journal of Cardiology, 2021; 37(12): 2026-2034.
26. SCHMIDT K, et al. Stress in Women with Acute Myocardial Infarction: A Closer Look/ Um Olhar sobre o Stress nas Mulheres com Infarto Agudo do Miocárdio. Arquivo Brasileiro de Cardiologia, 2020; 115(4): 649-657.
27. SÖRENSEN NA, et al. Relations of Sex to Diagnosis and Outcomes in Acute Coronary Syndrome. Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, 2018; 7(6).
28. STEHLI J, et al. Sex Differences Persist in Time to Presentation, Revascularization, and Mortality in Myocardial Infarction Treated With Percutaneous Coronary Intervention. Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, 2019; 8(10): e012161.
29. TIZÓN-MARCOS H, et al. Socioeconomic Status and Prognosis of Patients With ST-Elevation Myocardial Infarction Managed by the Emergency-Intervention “Codi IAM” Network. Frontiers in Cardiovascular Medicine, 2022; 9: 847982.
30. VALLABHAJOSYULA S, et al. Sex Disparities in the Use and Outcomes of Temporary Mechanical Circulatory Support for Acute Myocardial Infarction-Cardiogenic Shock. Canadian Journal of Cardiology, 2020; 2(6): 462-472.
31. VAN DER MEER MG, et al. Are there gender disparities in symptom presentation or triage of patients with chest discomfort at primary care out-of-hours services? An observational study. - BMJ Open, 2019; 9(11): e031613.
32. ZOU Y, et al. Sex differences in the management and clinical outcome among patients with acute coronary syndrome. BioMed Central cardiovascular disorders (Online), 2021; 21(1): 609.