medigraphic.com
ISSN 2954-3835 (Digital)
ISSN 2683-2828 (Impreso)

2026, Número 2

<< Anterior Siguiente >>

Cardiovasc Metab Sci 2026; 37 (2)


Paro cardiaco extrahospitalario y resucitación cardiopulmonar. ¿Hay diferencia de género?

Álvarez CJ, Asensio-La FE, García-Jiménez Y, Borrayo-Sánchez G, Mijangos-Chávez J, Hernández-García L

Idioma: Inglés [English version]
Referencias bibliográficas: 64
Paginas: 85-93
Archivo PDF: 935.93 Kb.


RESUMEN

La muerte súbita cardiaca (MSC) es casi el doble de frecuente en hombres que en mujeres. La principal causa en ambos grupos es la enfermedad arterial coronaria (EAC), pero la mayoría de las mujeres que presentan MSC no tienen antecedentes de cardiopatía, son asintomáticas o se han considerado sujetos de bajo riesgo de MSC. La prevención de la MSC en mujeres es más difícil, aunque se ha demostrado que el control de los factores de riesgo de la EAC reduce la incidencia de MSC. Las mujeres que sufren MSC suelen ser mayores, presentan más comorbilidades y tienen menos probabilidades de fallecer en espacios públicos. También reciben menos reanimación cardiopulmonar (RCP) por parte de testigos que los hombres. Generalmente presentan un ritmo inicial no desfibrilable y tienen menos probabilidades de sobrevivir a un paro cardiaco extrahospitalario (PCEH) y ser dadas de alta del hospital. El presente trabajo revisa las diferencias significativas en cuanto a factores de riesgo, tratamiento y resultados que deben impulsar acciones colectivas para reducir la carga de mortalidad por paro cardiaco en mujeres.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Albert CM, Chae CU, Grodstein F, Rose LM, Rexrode KM, Ruskin JN et al. Prospective study of sudden cardiac death among women in the United States. Circulation. 2003; 107: 2096-2101.

  2. Kong MH, Fonarow GC, Peterson ED, Curtis AB, Hernandez AF, Sanders GD et al. Systematic review of the incidence of sudden cardiac death in the United States. J Am Coll Cardiol. 2011; 57: 794-801.

  3. Myerburg RJ, Junttila MJ. Sudden cardiac death caused by coronary heart disease. Circulation. 2012; 125: 1043-1052.

  4. American Heart Association. Cardiac arrest statistics. Dallas (TX): American Heart Association; 2016.

  5. Weisfeldt M, Becker L. Racial differences in in-hospital cardiac arrest: good news: cautious optimism is welcome. JAMA Cardiol. 2017; 2: 984-985. doi: 10.1001/jamacardio.2017.2432

  6. Chugh SS, Jui J, Gunson K, Stecker EC, John BT, Thompson B et al. Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community. J Am Coll Cardiol. 2004; 44: 1268-1275.

  7. Simmons A, Pimentel R, Lakkireddy D. Sudden cardiac death in women. Rev Cardiovasc Med. 2012; 13: e37-e42.

  8. Glinge C, Jabbari R, Risgaard B, Lynge TH, Engstrom T, Albert CM et al. Symptoms before sudden arrhythmic death syndrome: a nationwide study among the young in Denmark. J Cardiovasc Electrophysiol. 2015; 26: 761-767. doi: 10.1111/jce.12674.

  9. Jabbari R, Risgaard B, Holst AG, Nielsen JB, Glinge C, Engstrom T et al. Cardiac symptoms before sudden cardiac death caused by coronary artery disease: a nationwide study among young Danish people. Heart. 2013; 99: 938-943. doi: 10.1136/heartjnl-2012-303534.

  10. Lynge TH, Risgaard B, Jabbari R, Glinge C, Bundgaard H, Maron B et al. Cardiac symptoms before sudden cardiac death caused by hypertrophic cardiomyopathy: a nationwide study among the young in Denmark. Europace. 2016; 18: 1801-1808. doi: 10.1093/europace/euv403.

  11. Sadjadieh G, Jabbari R, Risgaard B, Olesen MS, Haunso S, Tfelt-Hansen J et al. Nationwide (Denmark) study of symptoms preceding sudden death due to arrhythmogenic right ventricular cardiomyopathy. Am J Cardiol. 2014; 113: 1250-1254. doi: 10.1016/j.amjcard.2013.12.038.

  12. Schatzkin A, Cupples LA, Heeren T, Morelock S, Kannel WB. Sudden death in the Framingham Heart Study. Differences in incidence and risk factors by sex and coronary disease status. Am J Epidemiol. 1984; 120: 888-899.

  13. Kannel WB, Wilson PW, D'Agostino RB, Cobb J. Sudden coronary death in women. Am Heart J. 1998; 136: 205-212. doi: 10.1053/hj. 1998.v136.90226.

  14. Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N et al. Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008; 117 (4): e25-146.

  15. Haukilahti MAE, Holmstrom L, Vahatalo J, Kentta T, Tikkanen J, Pakanen L et al. Sudden cardiac death in women. Circulation. 2019; 139 (8): 1012-1021. doi: 10.1161/CIRCULATIONAHA.118.037702.

  16. Chugh SS, Uy-Evanado A, Teodorescu C, Reinier K, Mariani R, Gunson K et al. Women have a lower prevalence of structural heart disease as a precursor to sudden cardiac arrest: The ore-SUDS (Oregon Sudden Unexpected Death Study). J Am Coll Cardiol. 2009; 54 (22): 2006-2011.

  17. Adabag AS, Peterson G, Apple FS, Titus J, King R, Luepker RV. Etiology of sudden death in the community: results of anatomical, metabolic, and genetic evaluation. Am Heart J. 2010; 159: 33-39.

  18. Winkel BG, Risgaard B, Bjune T, Jabbari R, Lynge TH, Glinge C et al. Gender differences in sudden cardiac death in the young-a nationwide study. BMC Cardiovasc Disord. 2017; 17: 19. doi: 10.1186/s12872-016-0446-5.

  19. Hookana I, Holmstrom L, Eskuri MAE, Pakanen L, Ollila MM, Kiviniemi AM et al. Characteristics of women with ischemic sudden cardiac death. Ann Med. 2023; 55 (2): 2258911.

  20. Skjelbred T, Rajan D, Svane J, Lynge TH, Tfelt-Hansen J. Sex differences in sudden cardiac death in a nationwide study of 54 028 deaths. Heart. 2022; 108 (13): 1012-1018. doi: 10.1136/heartjnl-2021-320300.

  21. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002; 346 (12): 877-883.

  22. Lampert R, McPherson CA, Clancy JF, Caulin-Glaser TL, Rosenfeld LE, Batsford WP. Gender differences in ventricular arrhythmia recurrence in patients with coronary artery disease and implantable cardioverter-defibrillators. J Am Coll Cardiol. 2004; 43 (12): 2293-2299.

  23. Morrison LJ, Visentin LM, Kiss A, Theriault R, Eby D, Vermeulen M et al. Validation of a rule for termination of resuscitation in out-of-hospital cardiac arrest. N Engl J Med. 2006; 355 (5): 478-487.

  24. van Dongen LH, Smits RLA, van Valkengoed IGM, Elders P, Tan H, Blom MT. Individual-level income and out-of-hospital cardiac arrest survival in men and women. Open Heart. 2022; 9 (2): e002044.

  25. Kim LK, Looser P, Swaminathan RV, Horowitz J, Friedman O, Shin JH et al. Sex-based disparities in incidence, treatment, and outcomes of cardiac arrest in the United States, 2003-2012. J Am Heart Assoc. 2016; 5 (6): e003704. doi: 10.1161/JAHA.116.003704.

  26. Adabag AS, Luepker RV, Roger VL, Gersh BJ. Sudden cardiac death: epidemiology and risk factors. Nat Rev Cardiol 2010; 7: 216-225.

  27. Kim C, Fahrenbruch CE, Cobb LA, Eisenberg MS. Out-of-hospital cardiac arrest in men and women. Circulation. 2001; 104: 2699-2703.

  28. Wigginton JG, Pepe PE, Bedolla JP, DeTamble LA, Atkins JM. Sex-related differences in the presentation and outcome of out-of-hospital cardiopulmonary arrest: a multiyear, prospective, population-based study. Crit Care Med. 2002; 30 (4 Suppl): S131-S136

  29. Sanghavi P, Jena AB, Newhouse JP, Zaslavsky AM. Outcomes of basic versus advanced life support for out-of-hospital medical emergencies. Ann Intern Med. 2015; 163: 681-690. doi: 10.7326/M15-0557.

  30. Regitz-Zagrosek V. Sex and gender differences in health. Science & Society Series on Sex and Science. EMBO Rep. 2012; 13 (7): 596-603. doi: 10.1038/embor.2012.87.

  31. Bosson N, Kaji AH, Fang A, Thomas JL, French WJ, Shavelle D et al. Sex differences in survival from out-of-hospital cardiac arrest in the era of regionalized systems and advanced post-resuscitation care. J Am Heart Assoc. 2016; 5 (9): e004131. doi: 10.1161/JAHA.116.004131.

  32. Perman SM, Shelton SK, Knoepke C, Rappaport K, Matlock DD, Adelgais K et al. Public perceptions on why women receive less bystander cardiopulmonary resuscitation than men in out-of-hospital cardiac arrest. Circulation. 2019; 139 (8): 1060-1068. doi: 10.1161/CIRCULATIONAHA.118.037692.

  33. Chen C, Lo CYZ, Ho MJC, Ng Y, Chan HCY, Wu WHK et al. Global sex disparities in bystander cardiopulmonary resuscitation after out-of-hospital cardiac arrest: a scoping review. J Am Heart Assoc. 2024; 13 (18): e035794.

  34. Goodwin G, Picache D, Gaeto N, Louie BJ, Zeid T, Aung PP et al. Gender disparities in out-of-hospital cardiac arrests. Cureus. 2018; 10 (8): e3233. doi: 10.7759/cureus.3233.

  35. Blom MT, Oving I, Berdowski J, van Valkengoed IGM, Bardai A, Tan HL. Women have lower chances than men to be resuscitated and survive out-of-hospital cardiac arrest. Eur Heart J. 2019; 40 (47): 3824-3834.

  36. Kwak J, Ok Ahn K, Chan PS. Sex difference in the association between type of bystander CPR and clinical outcomes in patients with out of hospital cardiac arrest. Resusc Plus. 2022; 13: 100342.

  37. Wigginton JG, Pepe PE, Idris AH. Rationale for routine and immediate administration of intravenous estrogen for all critically ill and injured patients. Crit Care Med. 2010; 38 (10 Suppl): S620-S629. doi: 10.1097/CCM.0b013e3181f243a9.

  38. Mendelsohn ME. Protective effects of estrogen on the cardiovascular system. Am J Cardiol. 2002; 89 (12A): 12E-17E; discussion 17E-18E. doi: 10.1016/s0002-9149(02)02405-0.

  39. Bagnall RD, Weintraub RG, Ingles J, Duflou J, Yeates L, Lam L et al. A prospective study of sudden cardiac death among children and young adults. N Engl J Med. 2016; 374 (25): 2441-2452. doi: 10.1056/NEJMoa1510687.

  40. Marx JA, Hockberger RS, Walls RM, editors. Rosen's emergency medicine: concepts and clinical practice. 2-volume set. 8th ed. Philadelphia: Elsevier Health Sciences; 2014.

  41. Laopaiboon M, Lumbiganon P, Intarut N, Mori R, Ganchimeg T, Vogel JP et al. Advanced maternal age and pregnancy outcomes: a multicountry assessment. BJOG. 2014; 121 (Suppl 1): 49-56. doi: 10.1111/1471-0528.12659.

  42. Lamminpaa R, Vehvilainen-Julkunen K, Gissler M, Selander T, Heinonen S. Pregnancy outcomes of overweight and obese women aged 35 years or older - A registry-based study in Finland. Obes Res Clin Pract. 2016; 10 (2): 133-142. doi: 10.1016/j.orcp.2015.05.008.

  43. Shaikh N, Nawaz S, Chanda A, Nahid S, Zubair M, Ummunnisa F. Posteclampsia sudden cardiac arrest (SCA): a rare etiology. Case Rep Obstet Gynecol. 2020; 2020: 8862839.

  44. Semsarian C, Sweeting J, Ackerman MJ. Sudden cardiac death in athletes. BMJ. 2015; 350: h1218. doi: 10.1136/bmj.h1218.

  45. Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation. 2009; 119 (8): 1085-1092. doi: 10.1161/CIRCULATIONAHA.108.804617.

  46. Colombo CSSS, Finocchiaro G. The female athlete's heart: facts and fallacies. Curr Treat Options Cardiovasc Med. 2018; 20 (12): 101. doi: 10.1007/s11936-018-0699-7.

  47. Maron BJ, Haas TS, Murphy CJ, Ahluwalia A, Rutten-Ramos S. Incidence and causes of sudden death in U.S. college athletes. J Am Coll Cardiol. 2014; 63: 1636-1643. doi: 10.1016/j.jacc.2014.01.041.

  48. Reinier K, Rusinaru C, Chugh SS. Race, ethnicity, and the risk of sudden death. Trends Cardiovasc Med. 2019; 29 (2): 120-126. doi: 10.1016/j.tcm.2018.07.001.

  49. Zhao D, Post WS, Blasco-Colmenares E, Cheng A, Zhang Y, Deo R et al. Racial differences in sudden cardiac death. Circulation. 2019; 139: 1688-1697. doi: 10.1161/CIRCULATIONAHA.118.036553

  50. Yang SG, Mlcek M, Kittnar O. Gender differences in electrophysiological characteristics of idiopathic ventricular tachycardia originating from right ventricular outflow tract. Physiol Res. 2014; 63 Suppl 4: S451-S458. doi: 10.33549/physiolres.932920

  51. Marchlinski FE, Deely MP, Zado ES. Sex-specific triggers for right ventricular outflow tract tachycardia. Am Heart J. 2000; 139: 1009-1013. doi: 10.1067/mhj.2000.106164.

  52. Adielsson A, Hollenberg J, Karlsson T, Lindqvist J, Lundin S, Silfverstolpe J et al. Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia: bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in an 18-year perspective. Heart. 2011; 97 (17): 1391-1396.

  53. Akahane M, Ogawa T, Koike S, Tanabe S, Horiguchi H, Mizoguchi T et al. The effects of sex on out-of-hospital cardiac arrest outcomes. Am J Med. 2011; 124 (4): 325-333.

  54. Johnson MA, Haukoos JS, Larabee TM, Daugherty S, Chan PS, McNally B et al. Females of childbearing age have a survival benefit after out-of-hospital cardiac arrest. Resuscitation. 2013; 84 (5): 639-644.

  55. Kitamura T, Iwami T, Nichol G, Nishiuchi T, Hayashi Y, Nishiyama C et al. Reduction in incidence and fatality of out-of-hospital cardiac arrest in females of the reproductive age. Eur Heart J. 2010; 31 (11): 1365-1372.

  56. Teodorescu C, Reinier K, Uy-Evanado A, Ayala J, Mariani R, Wittwer L et al. Survival advantage from ventricular fibrillation and pulseless electrical activity in women compared to men: the Oregon Sudden Unexpected Death Study. J Interv Card Electrophysiol. 2012; 34 (3): 219-225.

  57. Khan E, Brieger D, Amerena J, Atherton JJ, Chew DP, Farshid A et al. Differences in management and outcomes for men and women with ST-elevation myocardial infarction. Med J Aust. 2018; 209: 118-123. doi: 10.5694/mja17.01109.

  58. Svennberg E, Birgersdotter-Green U. Chapter 76: Primary and secondary prevention of sudden cardiac death in women. In: Malik M, editor. Sex and cardiac electrophysiology: differences in cardiac electrical disorders between men and women. Amsterdam: Elsevier; 2020.

  59. Mandigers L, Termorshuizen F, de Keizer NF, Rietdijk WJR, Gommers D, Miranda DDR et al. Higher one-year mortality in women admitted to intensive care units after cardiac arrest: a nationwide overview from the Netherlands between 2010 and 2018. J Crit Care. 2021; 64: 176-183.

  60. Lakbar I, Ippolito M, Nassiri A, Delamarre L, Tadger P, Leone M et al. Sex and out-of-hospital cardiac arrest survival: a systematic review. Ann Intensive Care. 2022; 12 (1): 114. doi: 10.1186/s13613-022-01091-9.

  61. Safdar B, Stolz U, Stiell IG, Cone DC, Bobrow BJ, deBoehr M et al. Differential survival for men and women from out-of-hospital cardiac arrest varies by age: results from the OPALS study. Acad Emerg Med. 2014; 21 (12): 1503-1511.

  62. Álvarez de la Cadena Sillas J, Borrayo Sánchez G, Asensio La Fuente E. Muerte súbita en la mujer. En: Balderrabano N, Asensio La Fuente E, editores. Muerte súbita cardiaca. México: PYDESA; 2025. En prensa.

  63. Álvarez de la Cadena-Sillas J. The lack of CPR teaching in Mexico. Cardiovasc Metab Sci. 2024; 35 (1): 4-5.

  64. Álvarez-de la Cadena-Sillas J, Rangel-Alvarado MA, Asensio-Lafuente E, Hernández-García L. Cardiopulmonary resuscitation: beyond just giving chest compressions, ethical considerations. Cardiovasc Metab Sci. 2024; 35 (2): 65-70.




2020     |     www.medigraphic.com