Gender differences in the presentation, treatment, and short-term mortality of acute chest pain.
The Halifax County MONICA database was used to estimate the gender bias in presentation, prehospital and in-hospital treatment, and 28-d mortality of patients suffering an episode of acute chest pain. The study population consisted of all county residents aged 25-74, admitted between 1984 and 1990 to a CCU, or suffering a myocardial infarction anywhere in a hospital. The mean age for men was 58.5 (n = 6561), for women 61.5 (n = 3176). Women of all age groups were more likely to have a history of diabetes or hypertension, and below age 55 had a higher prevalence of peripheral vascular disease. Typical symptoms for infarction were present in 30.8% of women and 38.1% of men (p < 0.0001). More women were taking beta-blockers, Ca-antagonists, digitalis, diuretics, and nitrates (p < 0.001), and more men were on antiarrhythmics. A gender difference was observed for coronary arteriography (24% in men, 18% in women) and for the exercise stress test (23% in men, 18% in women). In hospital, men had more episodes of severe arrhythmias (OR = 1.52). Except for aspirin and antiarrhythmics, the difference in hospital medication and 28-d mortality (9.6% in women vs. 7.8% in men) could be explained by the existing clinical conditions.
Gregor
R D
RD
Department of Medicine, Dalhousie University, Halifax, Nova Scotia.
Bata
I R
IR
Eastwood
B J
BJ
Garner
J B
JB
Guernsey
J R
JR
MacKenzie
B R
BR
Rautaharju
P M
PM
Wolf
H K
HK
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000150:complications; D001241:Aspirin / Q000627:therapeutic use; D002637:Chest Pain / Q000401:mortality / Q000628:therapy; D017023:Coronary Angiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D012307:Risk Factors; D012737:Sex Factors
D000889:Anti-Arrhythmia Agents; D001241:Aspirin