title: Sex-based analysis of outcome in patients with acute myocardial infarction treated predominantly with percutaneous coronary intervention.
abstract: BACKGROUND
  A higher mortality risk for women with acute myocardial infarction (AMI) is a common finding in studies that compare the postinfarction outcome of women vs men. It is not clear, however, whether sex is an independent predictor of death among patients systematically treated with aggressive reperfusion and medical strategies.
  
  
  OBJECTIVE
  To assess the impact of patient's sex on outcome in a consecutive series of patients with AMI treated with a reperfusion strategy largely based on percutaneous coronary interventions.
  
  
  METHODS
  Inception cohort of 1937 patients (502 women and 1435 men) who were admitted with a diagnosis of AMI to a tertiary referral institution between January 1995 and December 2000.
  
  
  METHODS
  Mortality at 1 year after AMI.
  
  
  RESULTS
  Compared with men, women were older (70 vs 61 years; P<.001) and had known diabetes or hypertension more often. Both men and women received essentially identical therapy with the majority of patients (86%) receiving reperfusion therapy via percutaneous coronary interventions. There were no significant differences in 1-year Kaplan-Meier death rates with 13.8% (68 cases) among women and 12.9% (184 cases) among men (unadjusted hazard ratio, 1.06; 95% confidence interval, 0.80-1.39; P =.70). After age adjustment, women had a lower risk of death (hazard ratio, 0.65; 95% confidence interval, 0.49-0.87; P =.004).
  
  
  CONCLUSIONS
  Despite their more advanced age and greater prevalence of diabetes or hypertension, women with AMI who were treated with a reperfusion strategy largely based on percutaneous coronary interventions show a similar outcome as men.
authors.affiliation: Deutsches Herzzentrum, Lazarettstrasse 36, 80636 Munich, Germany.
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Josef
authors.initials: J
authors.lastname: Dirschinger
authors.forename: Jürgen
authors.initials: J
authors.lastname: Pache
authors.forename: Melchior
authors.initials: M
authors.lastname: Seyfarth
authors.forename: Rudolf
authors.initials: R
authors.lastname: Blasini
authors.forename: Donald
authors.initials: D
authors.lastname: Hall
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D016016:Proportional Hazards Models; D012306:Risk; D017678:Sex Distribution; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome