Is female sex an independent predictor of in-hospital mortality in acute myocardial infarction?

Pimenta, L; Bassan, Roberto; Potsch, Alfredo Antonio; Jf, Soares; Fm, Albanesi Filho

doi:10.1590/s0066-782x2001000700004

“…This result is consistent with the findings of several studies: in general males and females have different natural histories regarding AMI, the female's being a more aggressive form with high mortality rate [23][24][25].…”

Section: Discussionsupporting

confidence: 93%

Decomposing differences in acute myocardial infarction fatality in Italian regions

Francisci

¹

,

Gigli

²

,

Gesano

³

et al. 2008

Health Care Manage Sci

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The paper develops a general method for evaluating geographical differences in the outcome of acute myocardial infarction patients, by looking at the process of disease occurrence from infarction to hospitalization and possible death or recovery. The method is applied to regional data in Italy, where the long history of geographical diversities in economical, social and cultural fields is reflected in health care. Specific features of AMI, such as high fatality and fast course of the disease, make it a suitable tracer condition to investigate into the differences of regional health systems during the acute phase of hospitalization. The paper combines administrative and official statistics by region and offers a tool providing suggestions to policy-makers where further eventual investigations are needed around the care pathway and also what possible actions might be undertaken to improve the outcomes.

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“…Hapaz and colleagues evaluated the ethnic effect on survival after AMI in 5692 patients and demonstrated a higher inhospital and long term (7.1 (3.5) years) mortality rate in women than in men (57.6% v 43.3%). 5 In addition, the risk ratio differed significantly in women based on ethnic origin; lower in Jewish women born in central Europe compared with counterparts born in the Middle East.…”

Section: Discussionmentioning

confidence: 99%

“…4 5 Pimenta and colleagues studied 600 consecutive patients (435 men and 165 women) with AMI admitted to a hospital in Brazil and demonstrated higher mortality in women compared to men (23% v 9.9%, p = 0.02). 4 Furthermore, being female was an independent predictor of mortality (OR 2.73, p = 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have compared the outcome of women and men with AMI, with conflicting data. [2][3][4][5] The majority of these studies have been performed in western populations and so may not necessarily apply to other ethnic groups such as the Middle Eastern population. The aim of the present study was to determine the clinical characteristics and in-hospital mortality from AMI in Qatari women.…”

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confidence: 99%

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Mortality caused by acute myocardial infarction in Qatari women

Suwaidi

¹

2004

Heart

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T he long held belief that coronary heart disease (CHD) in women has a more benign prognosis than in men has resulted in less aggressive diagnosis and management patterns. Contrary to this belief, CHD is the leading cause of death in white women aged 60 years or older in the USA and outnumbers the next 16 causes of death in women combined, including cancers. Furthermore, since 1980, death from CHD has declined dramatically in men in the western world but has increased in women. 1With the recent recognition of this problem, considerable interest has been focused on the study of sex based differences in the outcome of patients with acute myocardial infarction (AMI) in the western world. Several studies have compared the outcome of women and men with AMI, with conflicting data.2-5 The majority of these studies have been performed in western populations and so may not necessarily apply to other ethnic groups such as the Middle Eastern population. The aim of the present study was to determine the clinical characteristics and in-hospital mortality from AMI in Qatari women. METHODSThis study was based at Hamad General Hospital, Doha, Qatar, which is the only tertiary care centre in the country and so all patients with AMI are treated here. The Hamad General Hospital cardiology database was used for this study; this database comprises data collected from all patients admitted to the cardiology department at the hospital since January 1991. Data were collected from the clinical records by the patients' physicians at the time of the patients' hospital discharge according to predefined criteria for each data point. We focused our study only on Qatari patients because it is a stable population and avoids the bias in the fluctuation of the expatriate population in the country. The study was approved by the institution review board.With the described database, all patients presenting with AMI in the period between 1991 and 2001 were identified. Age, sex, risk factors including smoking, hypertension, hypercholesterolaemia, diabetes, pre-existing coronary heart disease, in-hospital mortality and morbidity, as well as acute medical care provided were analysed. Data are expressed as mean (SD). Student's t test was employed for comparison between the mean values of the two groups and x 2 analysis was performed to test for differences in proportions of categorical variables between two or more groups. Multivariate stepwise regression analysis was used to identify predictors of outcome. A probability value of p , 0.05 was considered significant. RESULTSDuring the 10 year period a total of 20 856 patients were admitted to the coronary care unit and cardiology wards. Of these, 1598 Qatari patients were admitted with AMI; 1147 were male and 451 were female. When compared to men, women were older (62.1 (11.5) years v 59.9 (12.6) years, p , 0.001) and were more likely to have diabetes (68.5% v 48.3%, p , 0.001), hypertension (54.8% v 30.9%, p , 0.001), and hyperlipidaemia (30.4% v 24.9%, p = 0.029), but were less likely to be smokers (0....

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“…Data on the outcome of women after AMI are limited to the western population and to the best of our knowledge are limited to two studies in other communities. 4 5 Pimenta and colleagues studied 600 consecutive patients (435 men and 165 women) with AMI admitted to a hospital in Brazil and demonstrated higher mortality in women compared to men (23% v 9.9%, p = 0.02). 4 Furthermore, being female was an independent predictor of mortality (OR 2.73, p = 0.001).…”

Section: Discussionmentioning

confidence: 99%

Ventricular aneurysm secondary to sarcoid disease

Marks¹

2004

Heart

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T he long held belief that coronary heart disease (CHD) in women has a more benign prognosis than in men has resulted in less aggressive diagnosis and management patterns. Contrary to this belief, CHD is the leading cause of death in white women aged 60 years or older in the USA and outnumbers the next 16 causes of death in women combined, including cancers. Furthermore, since 1980, death from CHD has declined dramatically in men in the western world but has increased in women. 1With the recent recognition of this problem, considerable interest has been focused on the study of sex based differences in the outcome of patients with acute myocardial infarction (AMI) in the western world. Several studies have compared the outcome of women and men with AMI, with conflicting data.2-5 The majority of these studies have been performed in western populations and so may not necessarily apply to other ethnic groups such as the Middle Eastern population. The aim of the present study was to determine the clinical characteristics and in-hospital mortality from AMI in Qatari women. METHODSThis study was based at Hamad General Hospital, Doha, Qatar, which is the only tertiary care centre in the country and so all patients with AMI are treated here. The Hamad General Hospital cardiology database was used for this study; this database comprises data collected from all patients admitted to the cardiology department at the hospital since January 1991. Data were collected from the clinical records by the patients' physicians at the time of the patients' hospital discharge according to predefined criteria for each data point. We focused our study only on Qatari patients because it is a stable population and avoids the bias in the fluctuation of the expatriate population in the country. The study was approved by the institution review board.With the described database, all patients presenting with AMI in the period between 1991 and 2001 were identified. Age, sex, risk factors including smoking, hypertension, hypercholesterolaemia, diabetes, pre-existing coronary heart disease, in-hospital mortality and morbidity, as well as acute medical care provided were analysed. Data are expressed as mean (SD). Student's t test was employed for comparison between the mean values of the two groups and x 2 analysis was performed to test for differences in proportions of categorical variables between two or more groups. Multivariate stepwise regression analysis was used to identify predictors of outcome. A probability value of p , 0.05 was considered significant. RESULTSDuring the 10 year period a total of 20 856 patients were admitted to the coronary care unit and cardiology wards. Of these, 1598 Qatari patients were admitted with AMI; 1147 were male and 451 were female. When compared to men, women were older (62.1 (11.5) years v 59.9 (12.6) years, p , 0.001) and were more likely to have diabetes (68.5% v 48.3%, p , 0.001), hypertension (54.8% v 30.9%, p , 0.001), and hyperlipidaemia (30.4% v 24.9%, p = 0.029), but were less likely to be smokers (0....

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Is female sex an independent predictor of in-hospital mortality in acute myocardial infarction?

Abstract: After adjusting for all risk variables, female sex proved to be a variable independently related to in-hospital mortality in acute myocardial infarction.

Cited by 8 publications

References 33 publications

Decomposing differences in acute myocardial infarction fatality in Italian regions

Decomposing differences in acute myocardial infarction fatality in Italian regions

Mortality caused by acute myocardial infarction in Qatari women

Ventricular aneurysm secondary to sarcoid disease

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