Sex-based short- and long-term survival in patients following complicated myocardial infarction.
OBJECTIVE
Mortality in women following an acute myocardial infarction (AMI) is higher than in men, in that women are older and have more co-morbidity at the time of AMI. We evaluated short- and long-term sex-related differences in management and prognosis among high-risk patients following AMI.


RESULTS
A total of 1575 women and 3902 men with AMI and heart failure, left ventricular dysfunction, or anterior Q waves, were recruited for participation in the OPTIMAAL trial and followed for 2.7+/-0.9 years in seven European countries. Symptomatic heart failure was more common in women when compared with men. Women were older, with more hypertension and diabetes mellitus. Fewer women were treated with thrombolytics (P<0.001 in all cases). Women had a 1.37-fold higher risks of death (P<0.001) during follow-up, but no differences were observed after adjusting for age. However, in-hospital mortality was significantly higher in women (4.89 vs. 2.54%; P<0.001) and a 1.57-fold higher risk of in-hospital death (P=0.006) persisted after adjusting for age and co-morbidities.


CONCLUSIONS
Among high-risk patients with AMI, age-adjusted long-term survival was similar between sexes. However, adjusted in-hospital mortality was significantly higher in women. Higher short-term risk may warrant more rapid and appropriate management of women with AMI.
Bonarjee
Vernon V S
VV
University of Bergen, Stavanger University Hospital, Stavanger, Norway. bove@sir.no
Rosengren
Annika
A
Snapinn
Steven M
SM
James
Margaret K
MK
Dickstein
Kenneth
K
D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000401:mortality