Influência de gênero em sintomas de síndrome coronariana aguda
DOI:
https://doi.org/10.33233/eb.v17i2.2341Resumo
A Síndrome Coronariana Aguda (SCA) é um dos achados mais frequentes na prática clínica, que continua a apresentar grande morbidade e mortalidade, apesar dos avanços para seu tratamento. Este estudo tem como objetivo verificar quais são as diferenças na sintomatologia apresentada pelos gêneros na SCA com base em estudos clínicos prévios. Foi realizada uma revisão sistemática de artigos científicos publicados sobre o tema no período de 2006-2016, utilizando-se de bases de dados eletrônicas Lilacs, Capes, Pubmed e OvidMedline, nos idiomas português e inglês. Foram observadas significativas diferenças na apresentação sintomatológica da SCA entre homens e mulheres. Mulheres apresentam mais sintomas atípicos e dor precordial atípica ou ausente com mais frequência do que homens. Esse achado é relevante na prática clínica, fazendo-se necessário adotar medidas de alerta í população de risco, principalmente, e aos profissionais de saúde para que se evitem diagnósticos equivocados e se reduzam atrasos no diagnóstico e tratamento desses pacientes com apresentação sintomatológica atípica.
Palavras-chave: síndrome coronariana aguda, angina instável, infarto do miocárdio, sinais e sintomas, gênero e saúde.
Referências
Vedanthan R, Seligman B, Fuster V. Global perspective on acute coronary syndrome: a burden on the young and poor. Circ Res 2014;114(12):1959-75.
Zhao Z, Winget M. Economic burden of illness of acute coronary syndromes: medical and productivity costs. BMC Health Serv Res 2011;11:35.
Teich V, Araujo D. Estimativa de custo da sÃndrome coronariana aguda no Brasil. Rev Bras Cardiol 2011;24(2):85-94.
Bassan F, Bassan R. Abordagem da sindrome coronariana aguda. Revista da Sociedade de Cardiologia do Rio Grande do Sul 2006;07:1-7.
Hwang SY, Park EH, Shin ES, Jeong MH. Comparison of factors associated with atypical symptoms in younger and older patients with acute coronary syndromes. J Korean Med Sci 2009;24(5):789-94.
Canto JG, Goldberg RJ, Hand MM, Bonow RO, Sopko G, Pepine CJ et al. Symptom presentation of women with acute coronary syndromes: myth vs reality. Arch Intern Med 2007;167(22):2405-13.
Damasceno CA, Queiroz TL, Santos CAST, Mussi FC. Fatores associados à decisão para procura de serviço de saúde no infarto do miocárdio: diferenças entre gêneros. Rev Esc Enferm USP 2012;46(6):1362-70.
Khan NA, Daskalopoulou SS, Karp I, Eisenberg MJ, Pelletier R, Tsadok MA et al. Sex differences in acute coronary syndrome symptom presentation in young patients. JAMA Intern Med 2013;173(20):1863-71.
DeVon HA, Penckofer S, Larimer K. The association of diabetes and older age with the absence of chest pain during acute coronary syndromes. West J Nurs Res 2008;30(1):130-144.
DeVon HA, Rosenfeld A, Steffen AD, Daya M. Sensitivity, specificity, and sex differences in symptoms reported on the 13-item acute coronary syndrome checklist. J Am Heart Assoc 2014;3(2):e000586.
Leurent G, Garlantezec R, Auffret V, Hacot JP, Coudert I, Fillipi E, et al. Gender differences in presentation, management and inhospital outcome in patients with ST-segment elevation myocardial infarction: data from 5000 patients included in the ORBI prospective French regional registry. Arch Cardiovasc Dis 2014;107(5):291-8.
King KB, McGuire MA. Symptom presentation and time to seek care in women and men with acute myocardial infarction. Heart Lung 2007;36(4):235-43.
Alfredsson J, Stenestrand U, Wallentin L, Swahn E. Gender differences in management and outcome in non-ST-elevation acute coronary syndrome. Heart 2007;93(11):1357-62.
Radovanovic D, Erne P, Urban P, Bertel O, Rickli H, Gaspoz JM. Gender differences in management and outcomes in patients with acute coronary syndromes: results on 20,290 patients from the AMIS Plus Registry. Heart 2007;93(11):1369-75.
Sielski J, Sadowska AJ, Sadowski M, Kozielska EN, Gierlotka M, Poloński L, et al. Differences in presentation, treatment and prognosis in elderly patients with non-ST‑segment elevation myocardial infarction. Pol Arch Med Wewn 2012;122(6):253-61.
Hvelplund A, Galatius S, Madsen M, Rasmussen JN, Rasmussen S, Madsen JK, et al. Women with acute coronary syndrome are less invasively examined and subsequently less treated than men. Eur Heart J 2010;31(6):684-90.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation 2013;127(1):e6-e245.
Brieger D, Eagle K, Goodman S, Steg PG, Budaj A, White K, et al. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: insights from the global registry of acute coronary events. Chest 2004;126(2):461-9.
Ghezeljeh TN, Tessma MK, Emami A. Sex differences and symptoms of acute coronary syndrome. Client-Centered Nursing Care 2015;1(3):119-24.
Arslanian-Engoren C, Patel A, Fang J, Armstrong D, Kline-Rogers E, Duvernoy CS, et al. Symptoms of men and women presenting with acute coronary syndromes. Am J Cardiol 2006;98(9):1177-81.
Kosuge M, Kimura K, Ishikawa T, Ebina T, Hibi K, Tsukahara K et al. Differences between men and women in terms of clinical features of st-segment elevation acute myocardial infarction. Circ J 2006;70:222-6.
Nia SHS, Haghdost AA, Nazari R, Rezaie R, Sa'atsaz S, Andi SJS, et al. Difference in clinical symptoms of myocardial infarction between men and women. Iranian Journal of Critical Care Nursing 2011;4(1):33-8.
Noureddine S, Arevian M, Adra M, Puzantian H. Response to signs and symptoms of acute coronary syndrome: differences between lebanese men and women. American Journal of Critical Care 2008;17(1):26-35.
DeVon HA, Ryan C, Ochs A, Shapiro M. Symptoms across the continuum of acute coronary syndromes: differences between women and men. American Journal of Critical Care 2008;17(1):14-24.
Berg J, Bjorck L, Dudas K, Lappas G, Rosengren A. Symptoms of a first acute myocardial infarction in women and men. Gend Med 2009;6(3):454-62.
Behbahani N, Etemad K, Mehrabi Y, Ahmadi A, Hasani J. Difference in clinical manifestations of myocardial infarction between men and women in Iran in 2014-2015. International Journal of Epidemiologic Research 2016;3(2):106-11.
Canto JG, Rogers WJ, Goldberg RJ, Peterson ED, Wenger NK, Vaccarino V, et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA 2012;307(8):813-22.
Omran S, Al-Hassan M. Gender differences in signs and symptoms presentation and treatment of Jordanian myocardial infarction patients. Int J Nurs Pract 2006;12(4):198-204.
Rosenfeld AG, Knight EP, Steffen A, Burke L, Daya M, DeVon HA. Symptom clusters in patients presenting to the emergency department with possible acute coronary syndrome differ by sex, age, and discharge diagnosis. Heart Lung 2015;44(5):368-75.
Bruins Slot MHE, Rutten FH, van der Heijden GJMG, Doevendans PA, Mast EG, Bredero AC, et al. Gender differences in pre-hospital time delay and symptom presentation in patients suspected of acute coronary syndrome in primary care. Fam Pract 2012;29(3):332-37.
Pinto D, Lunet N, Azevedo A. Prevalência e determinantes de apresentação atÃpica de sÃndrome coronário agudo. Acta Med Port 2011;24(S2):307-18.
Coventry LL, Finn J, Bremner AP. Sex differences in symptom presentation in acute myocardial infarction: a systematic review and meta-analysis. Heart Lung 2011;40(6):477-91.
Shin JY, Martin R, Suls J. Meta-analytic evaluation of gender differences and symptom measurement strategies in acute coronary syndromes. Heart Lung 2010;39(4):283-95.
DeVon HA, Penckofer S, Larimer K. The association of diabetes and older age with the absence of chest pain dur-ing acute coronary syndromes. West J Nurs Res 2008;30(1):130-44.
Kirchberger I, Meisinger C, Heier M, Kling B, Wende R, Greschik C, et al. Patient-reported symptoms in acute myocardial infarction: differences related to ST-segment elevation: the MONICA/KORA Myocardial Infarction Registry. J Intern Med 2011;270(1):58-64.
Canto AJ, Kiefe CI, Goldberg RJ, Rogers WJ, Peterson ED, Wenger NK, et al. Differences in symptom presentation and hospital mortality according to type of acute myocardial infarction. Am Heart J 2012;163(4):572-9.
