title: Does diabetes mellitus explain the higher hospital mortality of women with acute myocardial infarction? Results from the Berlin Myocardial Infarction Registry.
abstract: BACKGROUND
  Women with acute myocardial infarction (AMI) exhibit greater hospital mortality than do men. In general, diabetes mellitus is one of the major factors influencing the outcome of patients with AMI. The aim of this study was to analyze the interaction between diabetes and gender, specifically with regard to the higher hospital mortality of female AMI patients aged < or = 75 years.
  
  
  METHODS
  We prospectively collected data from 3,715 patients aged < or = 75 (2,794 men, 921 women) with acute myocardial infarction who were treated in 25 hospitals in Berlin, Germany, from 1999 to 2002. In a multivariate analysis, we specifically studied the interaction between the factors diabetes mellitus and gender in their effects on hospital mortality.
  
  
  RESULTS
  After adjustment in multivariate analysis, the interaction between gender and diabetes was statistically significant, and the estimated odds ratios were as follows: female diabetic patients compared with male diabetic patients, odds ratio (OR) = 2.28 (95% confidence interval [CI] 1.42-3.68); female diabetic patients compared with male nondiabetic patients, OR = 2.90 (95% CI 1.90-4.42); and female diabetic patients compared with female nondiabetic patients, OR = 2.92 (95% CI 1.75-4.87). There was no statistically significant difference between the risk of dying for female nondiabetic patients or for male diabetic patients when compared with male nondiabetic patients.
  
  
  CONCLUSIONS
  In AMI patients aged < or = 75 years, female gender alone is not an independent predictor of hospital mortality. Detailed, multivariate analysis reveals that specifically diabetic women demonstrate higher hospital mortality than do men. Special attention should be provided to these female diabetic patients.
authors.affiliation: Interdisciplinary Network for Epidemiological Research in Berlin (EpiBerlin), Technische Universitaet Berlin, Ernst-Reuter-Platz 7, TEL 10-7, D-10587 Berlin, Germany. birga.maier@tuberlin.de
authors.forename: Birga
authors.initials: B
authors.lastname: Maier
authors.forename: Walter
authors.initials: W
authors.lastname: Thimme
authors.forename: Gerd
authors.initials: G
authors.lastname: Kallischnigg
authors.forename: Claudia
authors.initials: C
authors.lastname: Graf-Bothe
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Röhnisch
authors.forename: Claire
authors.initials: C
authors.lastname: Hegenbarth
authors.forename: Heinz
authors.initials: H
authors.lastname: Theres
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000401:mortality* / Q000628:therapy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality*; D011446:Prospective Studies; D012042:Registries; D012737:Sex Factors