A doença cardiovascular (DCV) é a causa número um de morte em todo mundo, responsável por 17.9 milhões de mortes por ano.[5]World Health Organization. Cardiovascular diseases (CVDs). Jun 2021 [internet publication].
https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
A cardiopatia isquêmica é a causa mais comum de morte cardiovascular; dados da ESC de 2019 mostraram que a cardiopatia isquêmica foi responsável por 38% das mortes por DCV em mulheres e 44% em homens.[1]Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC guidelines for the management of acute coronary syndromes. Eur Heart J. 2023 Oct 12;44(38):3720-826.
https://academic.oup.com/eurheartj/article/44/38/3720/7243210
http://www.ncbi.nlm.nih.gov/pubmed/37622654?tool=bestpractice.com
[6]Timmis A, Vardas P, Townsend N, et al. European Society of Cardiology: cardiovascular disease statistics 2021. Eur Heart J. 2022 Feb 22;43(8):716-99.
https://academic.oup.com/eurheartj/article/43/8/716/6472699
http://www.ncbi.nlm.nih.gov/pubmed/35016208?tool=bestpractice.com
A mortalidade por doença coronariana caiu nos últimos 30 anos na Europa e está diminuindo em muitos países desenvolvidos, mas está aumentando nos países em desenvolvimento e em transição, com mais de 75% das mortes por DCV ocorrendo nos países em desenvolvimento.[5]World Health Organization. Cardiovascular diseases (CVDs). Jun 2021 [internet publication].
https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
Essas tendências refletem mudanças na longevidade da população, na urbanização e nas mudanças de estilo de vida.[5]World Health Organization. Cardiovascular diseases (CVDs). Jun 2021 [internet publication].
https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
Nos EUA, estima-se que >800,000 pessoas sofrerão um infarto agudo do miocárdio (IAM) a cada ano.[2]Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2025 Apr;151(13):e771-862.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309
http://www.ncbi.nlm.nih.gov/pubmed/40014670?tool=bestpractice.com
[7]American College of Cardiology. ACC, AHA issue new acute coronary syndromes guideline: updated guideline recommends best practices for pharmacologic and surgical management of people with ACS. Feb 2025 [internet publication].
https://www.acc.org/About-ACC/Press-Releases/2025/02/28/17/51/ACC-AHA-Issue-New-Acute-Coronary-Syndromes-Guideline
A cardiopatia isquêmica é mais comum nos homens que nas mulheres.[6]Timmis A, Vardas P, Townsend N, et al. European Society of Cardiology: cardiovascular disease statistics 2021. Eur Heart J. 2022 Feb 22;43(8):716-99.
https://academic.oup.com/eurheartj/article/43/8/716/6472699
http://www.ncbi.nlm.nih.gov/pubmed/35016208?tool=bestpractice.com
[8]Martin SS, Aday AW, Allen NB, et al. 2025 Heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2025 Feb 25;151(8):e41-660.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001303
http://www.ncbi.nlm.nih.gov/pubmed/36695182?tool=bestpractice.com
Dados retrospectivos de 2010 a 2016 mostraram que a mortalidade intra-hospitalar nos EUA foi maior nas mulheres com infarto do miocárdio sem supradesnivelamento do segmento ST (IAMSSST) que nos homens (4.8% em comparação com 3.9%, com base em dados não ajustados). Essa diferença na mortalidade permaneceu após o controle para idade, comorbidades e fatores hospitalares.[9]Langabeer JR 2nd, Champagne-Langabeer T, Fowler R, et al. Gender-based outcome differences for emergency department presentation of non-STEMI acute coronary syndrome. Am J Emerg Med. 2019 Feb;37(2):179-82.
http://www.ncbi.nlm.nih.gov/pubmed/29754965?tool=bestpractice.com
Dados internacionais sugerem que a incidência do IAMSSST continua aumentando.[10]Neumann JT, Goßling A, Sörensen NA, et al. Temporal trends in incidence and outcome of acute coronary syndrome. Clin Res Cardiol. 2020 Sep;109(9):1186-92.
http://www.ncbi.nlm.nih.gov/pubmed/32034482?tool=bestpractice.com
[11]National Institute for Cardiovascular Outcomes Research. Interactive reports: clinical sub-specialty reports. 2024 [internet publication].
https://www.nicor.org.uk/interactive-reports
[12]Rogers WJ, Canto JG, Lambrew CT, et al. Temporal trends in the treatment of over 1.5 million patients with myocardial infarction in the US from 1990 through 1999: the National Registry of Myocardial Infarction 1, 2 and 3. J Am Coll Cardiol. 2000 Dec;36(7):2056-63.
https://www.sciencedirect.com/science/article/pii/S0735109700009967
http://www.ncbi.nlm.nih.gov/pubmed/11127441?tool=bestpractice.com
[13]McManus DD, Gore J, Yarzebski J, et al. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med. 2011 Jan;124(1):40-7.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3011975
http://www.ncbi.nlm.nih.gov/pubmed/21187184?tool=bestpractice.com
[14]Roger VL, Weston SA, Gerber Y, et al. Trends in incidence, severity, and outcome of hospitalized myocardial infarction. Circulation. 2010 Feb 23;121(7):863-9.
https://pmc.ncbi.nlm.nih.gov/articles/PMC2827641
http://www.ncbi.nlm.nih.gov/pubmed/20142444?tool=bestpractice.com
[15]Rogers WJ, Frederick PD, Stoehr E, et al. Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. Am Heart J. 2008 Dec;156(6):1026-34.
http://www.ncbi.nlm.nih.gov/pubmed/19032996?tool=bestpractice.com
Provavelmente isso é consequência de ensaios mais sensíveis para lesão miocárdica, farmacoterapia precoce, e reperfusão (e prevenção) do infarto do miocárdio com supradesnivelamento do segmento ST.[16]Alpert JS, Thygesen K, Antman E, et al. Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol. 2000 Sep;36(3):959-69.
https://www.sciencedirect.com/science/article/pii/S0735109700008044
http://www.ncbi.nlm.nih.gov/pubmed/10987628?tool=bestpractice.com