Gender differences in management and outcome of acute myocardial infarctions treated in 2006-2007.
OBJECTIVE
Women with acute myocardial infarction (AMI) previously received less invasive evaluation and experienced higher mortality than men. After improvements in AMI care it is unclear whether gender differences still exist in management and outcome of AMI.


METHODS
All patients admitted to Ullevål University Hospital for AMI during 2006 and 2007 were included in this cohort study. Predefined data were recorded during the hospital stay, and the survival status of the patients was ascertained on June 30, 2008.


RESULTS
A total of 931 women and 2,174 men were included. No gender differences were observed in treatment delay or age-adjusted odds ratio (OR) of invasive evaluation in ST-elevation myocardial infarction (STEMI). In non-ST-elevation myocardial infarction (NSTEMI), women were less likely than men to undergo coronary angiography (adjusted OR 0.72, 95% CI 0.53-0.99, p = 0.044) and percutaneous coronary intervention (adjusted OR 0.60, 95% CI 0.47-0.76, p = 0.0001). Age-adjusted in-hospital mortality and long-term survival were similar between men and women.


CONCLUSIONS
Women with STEMI experienced similar treatment delays and odds of invasive evaluation as men. However, gender differences in invasive evaluation were still observed in NSTEMI patients. No sex differences were observed in age-adjusted early and long-term mortality.
Department of Cardiology, Ullevål University Hospital, Oslo, Norway. sigrun.halvorsen@uus.no
Sigrun
S
Halvorsen
Jan
J
Eritsland
Michael
M
Abdelnoor
Charlotte
C
Holst Hansen
Cecilie
C
Risøe
Kjell
K
Midtbø
Reidar
R
Bjørnerheim
Arild
A
Mangschau
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality / Q000706:statistics & numerical data; D015331:Cohort Studies; D016001:Confidence Intervals; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D009664:Norway; D016017:Odds Ratio; D011336:Probability; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis; D015912:Thrombolytic Therapy / Q000401:mortality / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome