Lucy and the Iceman: Epidemiology of Ischemic Heart Disease
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Transcript of Lucy and the Iceman: Epidemiology of Ischemic Heart Disease
Heat Centre Nursing Education Day 2016
Lucy and the Iceman: Epidemiology of Ischemic Heart Disease
Karin H Humphries, DScUBC-Heart and Stroke Foundation Professor in Women’s Cardiovascular Health
Objectives
1. Describe the incidence, prevalence and mortality of IHD in BC/Canada
2. Describe differences in IHD pathophysiology between women and men
3. Describe differences in management of IHD between women and for men
Proportion with Type1 MI
Single Assay 50 ng/L Single Assay 26 ng/L34 ng/L Men
16 ng/L Women
Shah ASV et al BMJ 2015;350:g7873
ACS and Pre-Hospital Delay
Age Group Men Women
< 65 years 160 (84 - 365) 180 (95 - 420) < 0.05
65-74 years 180 (93 - 392) 195 (100 - 435) < 0.05
75-84 years 180 (95 - 392) 191 (100 - 442) < 0.05
> 85 years 177 (90 - 275) 190 (93 - 450) < 0.05
p = 0.17 p < 0.001
Summary
• Important differences exist between women and men in clinical
presentation, and response to treatment for ischemic heart disease
• Behavioural causes of sex-related differences may be more important
than biological factors
• A traditional diagnostic strategies, focusing on coronary obstruction,
and using a single cTn cut-point are likely to be inadequate in women
• Additional testing aimed at determining endothelial coronary
dysfunction may be useful to risk-stratify women with chest pain and
minimal or no obstructive coronary artery disease