title: Significant predictors of poor prognosis in women aged </=65 years hospitalized for an acute coronary event.
abstract: OBJECTIVE
  The aim of this study was to evaluate the importance of different clinical parameters predicting long-term cardiac prognosis in younger women with an acute coronary event.
  
  
  METHODS
  The Stockholm Female Coronary Risk Study is a follow-up study in women </=65 years.
  
  
  METHODS
  Patients were included between 1991 and 1994 from all 10 coronary care or intensive care units in the greater Stockholm area.
  
  
  METHODS
  A total of 335 consecutive female patients hospitalized for an acute coronary event.
  
  
  METHODS
  Cardiac death and nonfatal myocardial infarction (AMI).
  
  
  RESULTS
  During the follow-up period of 5 years there were 26 (8%) all cause deaths and 39 (12%) recurrent cardiac events. In the group that participated in the complete study, the following age adjusted parameters were found as strong predictors of adverse outcome: AMI as index event [Hazard Ratio (HR) 9.13, 95% CI 3.09-26.99], diabetes mellitus (HR 4.13, 95% CI 1.68-10.17), left ventricular dysfunction (HR 3.94, 95% CI 1.52-10.17), serum HDL cholesterol <1.0 mmol L-1 (HR 4.01, 95% CI 1.62-6.12), and serum triglycerides >2.0 mmol L-1 (HR 2.46, 95% CI 1.06-5.54). AMI as index event and diabetes mellitus were the most significant predictors in a multivariate statistical model. Diabetes mellitus was the strongest predictor when the analysis was repeated in the total patient cohort, integrating patients that did not participate in the extended investigations.
  
  
  CONCLUSIONS
  Women aged </=65-year-old hospitalized for an acute coronary event has a low rate of cardiac events during the following 5-year period. Easily obtained clinical variables such as diabetes mellitus predict adverse prognosis and implicates a need for a more active diagnostic and treatment strategy.
authors.affiliation: Department of Cardiology, Karolinska Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: F
authors.initials: F
authors.lastname: Al-Khalili
authors.forename: B
authors.initials: B
authors.lastname: Svane
authors.forename: I
authors.initials: I
authors.lastname: Janszky
authors.forename: L
authors.initials: L
authors.lastname: Rydén
authors.forename: K
authors.initials: K
authors.lastname: Orth-Gomér
authors.forename: K
authors.initials: K
authors.lastname: Schenck-Gustafsson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology