Sex Differences in Mortality After Myocardial Infarction

Vaccarino, Viola; Horwitz, Ralph I.; Meehan, Thomas P.; Petrillo, Marcia K.; Radford, Martha J.; Krumholz, Harlan M.

doi:10.1001/archinte.158.18.2054

Cited by 185 publications

(100 citation statements)

References 53 publications

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“…Several studies have indicated that shortand long-term post-MI (Koek et al 2006;Milcent et al 2007) and post-stroke mortality is higher in women than in men (Appelros et al 2009;Lewsey et al 2009;Appelros et al 2010;Andersen et al 2011). Some studies found that the female disadvantage in post-stroke survival was limited to younger ages (Vaccarino et al 1998(Vaccarino et al , 1999(Vaccarino et al , 2001Nielsen et al 2014), while others found that rates of post-MI and post-stroke survival did not differ significantly by gender after the baseline and clinical characteristics were taken into account (Galatius et al 1996;Herman et al 1997;MacIntyre et al 2001;Di Carlo et al 2003;Isaksson et al 2011;Olsen et al 2012).…”

Section: Sex Differences In Morbiditymentioning

confidence: 99%

Sex Differences in Health and Survival

Oksuzyan

Gumà

Doblhammer

2018

A Demographic Perspective on Gender, Family and Health in Europe

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Section: Sex Differences In Morbiditymentioning

confidence: 99%

Sex Differences in Health and Survival

Oksuzyan

Gumà

Doblhammer

2018

A Demographic Perspective on Gender, Family and Health in Europe

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“…Resultados -A letalidade hospitalar do IAM foi mais alta em mulheres (19,5% vs 9,4%) do que em homens (odds ratio (OR)= 2,34; IC 95%= 1,12-4,47 Embora diversos estudos mostrem, de forma consistente, maior mortalidade em mulheres do que em homens com IAM, as razões para esse fenômeno não estão devidamente esclarecidas [1][2][3][4][5][6][7][8][9][10] . Estudos conduzidos fora do Brasil, no entanto, sugerem que a idade mais avançada, a maior gravidade da insuficiência ventricular esquerda (IVE) e fatores relacionados com à terapêutica, podem, em conjunto, contribuir para a maior letalidade do IAM entre as mulheres.…”

Section: Métodos -Estudo De Coorte Retrospectivo Envolvendo 388 Paciunclassified

Por que a letalidade hospitalar do infarto agudo do miocárdio é maior nas mulheres?

Passos¹,

Lopes²,

Barbosa³

et al. 1998

Arq. Bras. Cardiol.

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Purpose -To assess the influence of age, disease severity at admission and therapeutic interventions on the higher in-hospital case-fatality rate of acute myocardial infarction (MI) in women.Methods -A retrospective cohort study involving a total of 388 acute MI patients (50 deaths (OR=1.99;. This association became weaker after taking into account disease severity at admission (OR=1.84;) and therapeutic interventions for acute MI (OR=1.50; IAM (com ou sem ondas Q), comorbidades, história de acidente vascular cerebral e intervenções terapêuticas para o IAM (ácido acetil-salicílico, betabloqueadores e agentes trombolíticos). Modelos de regressão logística foram usados para avaliar a influência de potenciais variáveis confundidoras na associação entre sexo e letalidade hospitalar do IAM.Resultados -A letalidade hospitalar do IAM foi mais alta em mulheres (19,5% vs 9,4%) do que em homens (odds ratio (OR)= 2,34; IC 95%= 1,47). Embora as mulheres fossem significantemente (p<0,01) mais idosas, a associação entre sexo e morte reduziu-se em apenas 15% após ajuste para idade (OR= 1,99; IC 95 %= 1,67). Esta associação tornou-se mais fraca ao se considerar a gravidade da doença na admissão (OR= 1,84; IC 95%= 0,74) e intervenções terapêuticas para o IAM (OR= 1,50; IC= 0,38 Em contraste com a incidência do infarto agudo do miocárdio (IAM), maior entre homens, a letalidade hospitalar do IAM é maior entre as mulheres [1][2][3][4][5] . Em Salvador, o nú-mero de mortes por IAM vem crescendo desde o final dos

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“…These studies have consistently shown that women are, on average, 10 years older at presentation; have a higher burden of comorbidities; and are less likely to receive up‐to‐date treatment, including reperfusion therapy, than men 7. Accounting for age differences often attenuates the observed sex differences in all‐cause mortality, suggesting that age‐associated comorbidity accounts for the excess risk in women 2, 3…”

Section: Introductionmentioning

confidence: 98%

“…Studies have identified that women have higher all‐cause mortality than men following acute myocardial infarction (AMI) 1, 2, 3, 4, 5, 6. These studies have consistently shown that women are, on average, 10 years older at presentation; have a higher burden of comorbidities; and are less likely to receive up‐to‐date treatment, including reperfusion therapy, than men 7.…”

Section: Introductionmentioning

confidence: 99%

Influence of Ethnicity, Age, and Time on Sex Disparities in Long‐Term Cause‐Specific Mortality After Acute Myocardial Infarction

Gao

Lam

Yeo

et al. 2016

JAHA

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BackgroundWe examined the influence of sex, ethnicity, and time on competing cardiovascular and noncardiovascular causes of death following acute myocardial infarction in a multiethnic Asian cohort.Methods and ResultsFor 12 years, we followed a prospective nationwide cohort of 15 151 patients (aged 22–101 years, median age 63 years; 72.3% male; 66.7% Chinese, 19.8% Malay, 13.5% Indian) who were hospitalized for acute myocardial infarction between 2000 and 2005. There were 6463 deaths (4534 cardiovascular, 1929 noncardiovascular). Compared with men, women had a higher risk of cardiovascular death (age‐adjusted hazard ratio [HR] 1.3, 95% CI 1.2–1.4) but a similar risk of noncardiovascular death (HR 0.9, 95% CI 0.8–1.0). Sex differences in cardiovascular death varied by ethnicity, age, and time. Compared with Chinese women, Malay women had the greatest increased hazard of cardiovascular death (HR 1.4, 95% CI 1.2–1.6) and a marked imbalance in death due to heart failure or cardiomyopathy (HR 3.4 [95% CI 1.9–6.0] versus HR 1.5 [95% CI 0.6–3.6] for Indian women). Compared with same‐age Malay men, Malay women aged 22 to 49 years had a 2.5‐fold (95% CI 1.6–3.8) increased hazard of cardiovascular death. Sex disparities in cardiovascular death tapered over time, least among Chinese patients and most among Indian patients; the HR comparing cardiovascular death of Indian women and men decreased from 1.9 (95% CI 1.5–2.4) at 30 days to 0.9 (95% CI 0.5–1.6) at 10 years.ConclusionAge, ethnicity, and time strongly influence the association between sex and specific cardiovascular causes of mortality, suggesting that health care policy to reduce sex disparities in acute myocardial infarction outcomes must consider the complex interplay of these 3 major modifying factors.

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Sex Differences in Mortality After Myocardial Infarction

Abstract: Background: Studies of sex differences in mortality after myocardial infarction (MI) have shown conflicting results.

Cited by 185 publications

References 53 publications

Sex Differences in Health and Survival

Sex Differences in Health and Survival

Por que a letalidade hospitalar do infarto agudo do miocárdio é maior nas mulheres?

Influence of Ethnicity, Age, and Time on Sex Disparities in Long‐Term Cause‐Specific Mortality After Acute Myocardial Infarction

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