The role of gender in the long-term prognosis of patients with myocardial infarction submitted to fibrinolytic treatment.
OBJECTIVE
To determine the role of gender in short- and long-term survival after a thrombolytic-treated myocardial infarction.


METHODS
A total of 686 consecutive patients with ST-elevation acute myocardial infarction, admitted to a single center and treated with intravenous streptokinase, were studied prospectively and consecutively. Assessment of clinical and in-hospital variables permitted comparison of baseline characteristics and both in-hospital and long-term survival between men and women.


RESULTS
A significantly (odds ratio=0.48, P=0.009) lower 14-day mortality rate for males (8.5%) relative to females (16%) was noted. However, this difference became non-significant after adjustment for age (odds-ratio male/female=0.62, P=0.097) or age and other variables (odds ratio=0.71, P=0.17). At the end of the follow-up (up to 12 years), survival rates for the whole population were 59.6% and 54.4% for men and women, respectively (chi-square=1.4, P=0.24); excluding in-hospital deaths, the rates were 65.1% and 64.8%, respectively (chi-square=0.21, P=0.65).


CONCLUSIONS
In the short-term follow-up, women have a significantly higher mortality relative to men in an unadjusted analysis. This difference became non-significant after adjusting for age, or age and other variables. In the long-term follow-up, sex was not correlated with prognosis.
Nicolau
José Carlos
JC
Heart Institute (InCor), University of São Paulo Medical School, Brazil. corjnicolau@incor.usp.br
Auxiliadora Ferraz
Maria
M
Nogueira
Paulo Roberto
PR
Coimbra Garzon
Sérgio Aloízio
SA
Serrano
Carlos V
CV
Ramires
José Antonio F
JA
D001938:Brazil / Q000453:epidemiology; D006328:Cardiac Catheterization; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013300:Streptokinase / Q000627:therapeutic use*; D016019:Survival Analysis; D013995:Time; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D013300:Streptokinase