Hospitalisations, infarct development, and mortality in patients with chest pain and a normal admission electrocardiogram in relation to gender.
BACKGROUND
The aim of this study was to compare the outcome for men and women with chest pain or other symptoms suggestive of acute myocardial infarction (AMI) and a normal ECG on admission.


METHODS
All patients who presented to our emergency room over a 21-month period with chest pain or other symptoms suggestive of AMI were prospectively followed for 1 year, whether they were hospitalised or not.


RESULTS
Of 5201 registered patients a normal ECG was found in 2691, of whom 700 men and 559 women were hospitalised while 752 men and 680 women were not hospitalised. As many women (45%) as men (48%) were hospitalised, but fewer women were admitted to the coronary care unit in the first instance (8.6% versus 15.2%; P < 0.001). More men than women (9.3% versus 2.7%; P < 0.001) who were hospitalised developed AMI during hospitalisation, but there was no difference during 1 year between men and women who were not hospitalised regarding AMI development (1.5% versus 1.4%; NS). There was no difference in in-hospital complications between men and women. Mortality for men and women during hospitalisation (1.6% versus 1.1%) or during 1 year (4.2% versus 4.5% for hospitalised and 1.2% versus 1.2% for not hospitalised patients) did not differ.


CONCLUSIONS
Among patients with suspected AMI and a normal ECG on admission women were less often admitted to the coronary care unit and less often developed AMI during hospitalisation than men. Men and women had the same mortality during hospitalization and during 1 year.
Karlson
B W
BW
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Herlitz
J
J
D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002637:Chest Pain / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D003325:Coronary Care Units; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D009204:Myocardial Revascularization; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate
D002317:Cardiovascular Agents