title: Predictors of in-hospital mortality difference between male and female patients with acute myocardial infarction.
abstract: Many studies have demonstrated that, compared with men, women have increased long- and short-term mortality after acute myocardial infarction (AMI). The reasons for this mortality difference remain in dispute. We analyzed baseline characteristics, in-hospital management, and short-term outcomes of 1,246 men and 537 women with AMI to identify clinical variables that can predict the in-hospital mortality difference between genders. A higher in-hospital mortality was found in women with AMI than in men (11.9% vs 6.9%, p <0.001). Women were generally older, had a higher incidence of hypertension, diabetes mellitus, and hyperlipidemia, and had a higher Killip class of cardiac function compared with men. Reperfusion therapy and beta-receptor blockers were underused in women. Using a multivariate logistic regression model, we identified age, history of hypertension and diabetes mellitus, Killip class of cardiac function, and administration of reperfusion therapy and beta-receptor blockers as significant predictors of in-hospital mortality in patients with AMI, with odds ratios of 1.05 (95% confidence interval [CI] approximately 1.03 to 1.07), 1.65 (95% CI 1.12 to 2.41), 1.92 (95% CI 1.27 to 2.90), 3.62 (95% CI 2.88 to 4.56), 0.39 (95% CI 0.24 to 0.66), and 0.63 (95% CI 0.43 to 0.93), respectively. In conclusion, women with AMI had a higher in-hospital mortality rate than did men, probably due to older age, higher incidence of hypertension, diabetes mellitus, and hyperlipidemia, a higher Killip class of cardiac function, and less utilization of reperfusion therapy and beta-receptor blockers.
authors.affiliation: The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Shandong University Qilu Hospital, Jinan, Shandong, People's Republic of China.
authors.forename: Shi Liang
authors.initials: SL
authors.lastname: Jiang
authors.forename: Xiao Ping
authors.initials: XP
authors.lastname: Ji
authors.forename: Yu Xia
authors.initials: YX
authors.lastname: Zhao
authors.forename: Xiao Rong
authors.initials: XR
authors.lastname: Wang
authors.forename: Zhao Feng
authors.initials: ZF
authors.lastname: Song
authors.forename: Zhi Ming
authors.initials: ZM
authors.lastname: Ge
authors.forename: Tao
authors.initials: T
authors.lastname: Guo
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhang
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors