title: Trends in gender difference in mortality after acute myocardial infarction.
abstract: BACKGROUND
  Progress in management of acute myocardial infarction (AMI) might have changed the effect of gender on mortality.
  
  
  METHODS
  From May 1981 to November 2002, 1984 consecutive patients with AMI underwent emergency coronary angiography. They were divided into three groups in chronological order: group I (1981-1988, n=564); group II (1989-1995, n=678); and group III (1997-2002, n=742). Multi-variable analysis was performed using Cox's proportional hazard regression, adjusting baseline clinical and angiographical variables.
  
  
  RESULTS
  There were 405 women (20%). Thrombolysis was most frequently performed in group I (50%), balloon angioplasty in group II (71%), and stent in group III (66%), with no difference in the allocation of reperfusion therapy between men and women. Three-year mortality was significantly higher in women than in men in group I (27% vs 18%, p=0.03) and group II (23% vs 15%, p=0.048). In group III, there was no significant difference in 3-year mortality (12% vs 10%, p=0.66) between women and men. Women were associated with higher age, more diabetes, more hypertension, fewer current smokers, and less previous infarction than men. Multi-variable analysis showed that sex was not an independent predictor of 3-year mortality in the three groups.
  
  
  CONCLUSIONS
  Women with AMI who were treated mostly with primary intervention using stent in the contemporary era had similar mortality to men.
authors.affiliation: Department of Cardiology, Hiroshima City Hospital, 7-33, Moto-machi, Naka-ku, Hiroshima 730-8518, Japan. ishifami@fb3.so-net.ne.jp
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Ichiro
authors.initials: I
authors.lastname: Inoue
authors.forename: Takuji
authors.initials: T
authors.lastname: Kawagoe
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimatani
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurisu
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakama
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Maruhashi
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kagawa
authors.forename: Kazuoki
authors.initials: K
authors.lastname: Dai
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsushita
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikenaga
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012737:Sex Factors; D015607:Stents; D015912:Thrombolytic Therapy