Impact of age and gender on in-hospital and late mortality after acute myocardial infarction: increased early risk in younger women: results from the French nation-wide USIC registries.
OBJECTIVE
To determine whether sex differences of in-hospital and after-discharge mortality differ according to the age.


RESULTS
Data of 4347 consecutive patients hospitalized within 48 h of the onset of acute myocardial infarction (AMI) were analysed. Patients were classified according to median age (68 years): Group 1 (G1) (308 women, 30-67 years), G2 (1878 men, 30-67 years), G3 (860 women, 68-89 years), and G4 (1301 men, 68-89 years). In both age groups, women were older, had more frequent co-morbidities, lower rate of reperfusion therapy, and received less anti-platelet agents, beta-blockers, and statins than men. The overall 1-year mortality was higher in women (25% vs. 16% in men, P<0.0001). After adjustment, in-hospital mortality was higher only for the women in the younger age group. (G1 vs. G2: OR=2.2, 95%CI=1.3-3.8; G3 vs. G4: OR=1.1, 95%CI=the risk of death, after hospital discharge, was no longer related to gender in any age group.


CONCLUSIONS
The higher 1-year mortality following AMI in women is explained by the higher risk of death in young women during the first days of hospitalization. Further investigations are crucial to determine the cause in order to improve the chance of survival in younger women.
Simon
Tabassome
T
Department of Pharmacology, Saint-Antoine, Pierre et Marie Curie University, 27 Rue Chaligny, 75012 AP-HP, and Department of Cardiology, Hôpital Européen Georges Pompidou, Paris, France. tabassome.simon@chusa.jussieu.fr
Mary-Krause
Murielle
M
Cambou
Jean-Pierre
JP
Hanania
Guy
G
Guéret
Pascal
P
Lablanche
Jean-Marc
JM
Blanchard
Didier
D
Genès
Nathalie
N
Danchin
Nicolas
N
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis