Increased cardiac mortality in women compared with men in patients with acute myocardial infarction.
OBJECTIVE
It has been reported that women with acute myocardial infarction (AMI) have a higher short-term mortality rate than men, but the reason is not known. The profile in relation to age, gender and risk factors was evaluated to compare AMI and unstable angina pectoris (UAP).


METHODS
Findings from 984 patients including 580 patients with AMI (129 women, 451 men) and 404 patients with UAP (131 women, 273 men) were analyzed by the South Osaka Acute Coronary Syndrome Study Group (SACS). The primary endpoint of the study was in-hospital death. The primary endpoints of interest (cardiac death) were fatal recurrent myocardial infarction, death from congestive heart failure, and sudden death.


RESULTS
Cardiac death during hospitalization within 30 days in AMI was higher in women than in men (12.4% vs 6.7%, p < 0.05). On the other hand, in UAP there was no significant difference between women and men (1.5% vs 0.7%, NS). The incidence of cardiac death in AMI was significantly higher for patients 75 years old and older (19.0%) than for patients less than 55 years old (4.2%), 55-64 years old (3.5%) and 65-74 years old (4.7%) (p < 0.001, respectively).


CONCLUSIONS
Cardiac death was higher for women compared with men in patients with AMI. The worse prognosis for the AMI women patients was likely to be derived from less performance of percutaneous coronary intervention, and a high incidence of severe myocardial infarction. Further research should be focused on the analysis of various clinical backgrounds.
Kanamasa
Ken
K
Department of Vascular and Geriatric Medicine, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osakasayama, Osaka 589-8511.
Ishikawa
Kinji
K
Hayashi
Takahiro
T
Hoshida
Shiro
S
Yamada
Yoshio
Y
Kawarabayashi
Takahiko
T
Naka
Masashi
M
Yokoi
Yoshiaki
Y
Matsuda
Mitsuo
M
Ogawa
Iwao
I
D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000401:mortality; D005260:Female; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D007297:Inpatients; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D013997:Time Factors