title: Comparison of management and 30-day mortality of acute myocardial infarction in men versus women in Estonia.
abstract: OBJECTIVE
  There is conflicting information about gender differences in clinical features, management and outcome after acute myocardial infarction (AMI). The objective of the study was to compare the baseline characteristics, management and 30-day mortality of AMI in men and women in Estonia.
  
  
  METHODS
  This study included consecutive unselected patients from the Myocardial Infarction Registry (MIR) in Estonia, who were admitted to a university hospital between January 2001 and February 2002. Logistic regression analysis was used to estimate crude and adjusted odds ratios (OR) with 95 percent confidence intervals (95% CI).
  
  
  RESULTS
  The study included 228 men and 167 women. Women were older than men (73.49 +/- 10.95 vs. 65.63 +/- 12.60, p < 0.000), and had more comorbidities. After age-adjustment, the higher prevalence of comorbidities, like diabetes (age-adjusted odds ratio [OR] 2.48, 95% confidence intervals [CI] 1.45-4.24), hypertension (OR 1.78, 95% CI 1.15-2.76) and history of congestive heart failure (OR 2.14, 95% CI 1.32-3.46) in women was preserved. Women were more frequently treated with diuretics (OR 2.68, 95% CI 1.69-4.25) and less frequently with statins (OR 0.61, 95% CI 0.39-0.96), after age-adjustment. Although thrombolytic therapy, coronary angiography and angioplasty were performed less frequently in women, these differences disappeared after age-adjustment. Female gender was not an independent predictor of 30-day mortality after AMI, crude OR was 1.39, 95% CI 0.80 to 2.41, adjustment for age and other covariates reduced OR to 0.98, 95% CI 0.44 to 2.20.
  
  
  CONCLUSIONS
  Among AMI-patients, age but not gender is an important determinant of care and early mortality.
authors.affiliation: Department of Cardiology, University of Tartu, Tartu, Estonia. Tiia.Bakler@kliinikum.ee
authors.forename: Tiia
authors.initials: T
authors.lastname: Bakler
authors.forename: Aleksei
authors.initials: A
authors.lastname: Baburin
authors.forename: Rein
authors.initials: R
authors.lastname: Teesalu
authors.forename: Mati
authors.initials: M
authors.lastname: Rahu
mesh_terms: D000208:Acute Disease; D000368:Aged; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality* / Q000628:therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011287:Prejudice; D012042:Registries; D012737:Sex Factors; D013997:Time Factors