Mortality Differences Between Men and Women Following First Myocardial Infarction

Abstract

Context.-Mortality after acute myocardial infarction is worse in women than in men, even after adjustment for comorbidity and age dissimilarities between sexes. Objective.-To assess the influence of sex on survival after acute myocardial infarction. Design.-Inception cohort obtained in a prospective registry of patients with acute myocardial infarction from 1992 through 1994. Setting.-Four teaching hospitals in northeastern Spain. Patients.-All consecutive patients aged 80 years or younger with first acute myocardial infarction. A total of 331 women and 1129 men were included. Main Outcome Measure.-Survival at 28 days and mortality or readmission at 6 months. Results.-Women were older (mean, 68.6 vs 60.1 years), presented more often with diabetes (52.9% vs 23.3%), hypertension (63.9% vs 42.3%), or previous angina (44.6% vs 37.4%), and developed more severe myocardial infarctions than men (acute pulmonary edema or cardiogenic shock occurred in 24.8% of women and 10.5% of men) (all PϽ.02). Men were more likely than women to receive thrombolytic therapy (41.3% vs 23.9%; PϽ.001), but rates of percutaneous transluminal angioplasty and coronary artery bypass graft surgery at 28 days were similar among men and women. The 28-day mortality rate was significantly higher among women (18.5% for women, 8.3% for men; PϽ.001). Revascularization procedures at 6 months were performed in a similar proportion of women and men. However, women had higher 6-month mortality rates (25.8% in women, 10.8% in men; PϽ.001) and readmission rates (23.3% for women, 12.2% for men; PϽ.001). After adjustment, women had greater risk of death than men at 28 days (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.12-2.65) and at 6 months (OR, 1.73; 95% CI, 1.18-2.52). Conclusions.-In this study population, women experienced more lethal and severe first acute myocardial infarction than men, regardless of comorbidity, age, or previous angina.

Sex Differences in Clinical Characteristics, Hospital Management Practices, and In-Hospital Outcomes in Patients Hospitalized in a Vietnamese Hospital with a First Acute Myocardial Infarction

“…Previous studies examining sex differences in clinical presentation, management practices, and in the risk of developing clinically important hospital complications and dying in the setting of acute myocardial infarction (AMI) have been primarily conducted in developed countries [1]–[10]. While some studies found that women had higher in hospital case-fatality rates compared with men [1], [2], [8]–[10], other studies have not [3]–[7].…”

“…While some studies found that women had higher in hospital case-fatality rates compared with men [1], [2], [8]–[10], other studies have not [3]–[7]. There are very few studies, however, that have been carried out in low- and middle -income countries (LMICs) [11]–[14] and more observational studies are needed to monitor and improve health outcomes in patients hospitalized with AMI [15].…”

Fasting Hyperglycemia Increases In-Hospital Mortality Risk in Nondiabetic Female Patients with Acute Myocardial Infarction: A Retrospective Study

“…Gender disparity in clinical outcome of AMI patients with or without T2DM is still elusive. Women with AMI are more inclined to gain a poorer outcome than men [1–3]. Plasma glucose is often considered as an important predictor of mortality after AMI [3–6].…”

Cost and clinical consequences of smoking cessation in outpatients after cardiovascular disease: a retrospective cohort study

“…In Spain, the prevalence of smoking among patients with acute myocardial infarction is 35% and around 32% in patients with angina. In general, it has been calculated that 29% of the deaths due to coronary disease are due to smoking and that one in every three deaths caused by smoking is premature 6,7. Various studies have shown a correlation between the number of cigarettes smoked (dose-response) and the number of arteries affected, to the extent that the relative risk is close to 5.5 for fatal cardiovascular episodes in smoking patients in comparison with never smokers 8.…”