title: Sex differences in clinical characteristics, hospital management practices, and in-hospital outcomes in patients hospitalized in a Vietnamese hospital with a first acute myocardial infarction.
abstract: BACKGROUND
  Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with acute myocardial infarction (AMI) at the Vietnam National Heart Institute in Hanoi. The objectives of this observational study were to examine sex differences in clinical characteristics, hospital management, in-hospital clinical complications, and mortality in patients hospitalized with an initial AMI.
  
  
  METHODS
  The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010.
  
  
  RESULTS
  The average age of study patients was 66 years and one third were women. Women were older (70 vs. 64 years) and were more likely than men to have had hyperlipidemia previously diagnosed (10% vs. 2%). During hospitalization, women were less likely to have undergone percutaneous coronary intervention (PCI) compared with men (57% vs. 74%), and women were more likely to have developed heart failure compared with men (19% vs. 10%). Women experienced higher in-hospital case-fatality rates (CFRs) than men (13% vs. 4%) and these differences were attenuated after adjustment for age and history of hyperlipidemia (OR: 2.64; 95% CI: 1.01, 6.89), and receipt of PCI during hospitalization (OR: 2.09; 95% CI: 0.77, 5.09).
  
  
  CONCLUSIONS
  Our pilot data suggest that among patients hospitalized with a first AMI in Hanoi, women experienced higher in-hospital CFRs than men. Full-scale surveillance of all Hanoi residents hospitalized with AMI at all Hanoi medical centers is needed to confirm these findings. More targeted and timely educational and treatment approaches for women appear warranted.
authors.affiliation: Institute of Population, Health and Development, Ha Noi, Viet Nam; Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam.
authors.forename: Hoa L
authors.initials: HL
authors.lastname: Nguyen
authors.affiliation: Ministry of Health, Ha Noi, Viet Nam.
authors.forename: Duc Anh
authors.initials: DA
authors.lastname: Ha
authors.affiliation: Viet Nam National Heart Institute, Ha Noi, Viet Nam.
authors.forename: Dat Tuan
authors.initials: DT
authors.lastname: Phan
authors.affiliation: Viet Nam National Heart Institute, Ha Noi, Viet Nam.
authors.forename: Quang Ngoc
authors.initials: QN
authors.lastname: Nguyen
authors.affiliation: Viet Nam National Heart Institute, Ha Noi, Viet Nam.
authors.forename: Viet Lan
authors.initials: VL
authors.lastname: Nguyen
authors.affiliation: Institute of Population, Health and Development, Ha Noi, Viet Nam.
authors.forename: Nguyen Hanh
authors.initials: NH
authors.lastname: Nguyen
authors.affiliation: Institute of Population, Health and Development, Ha Noi, Viet Nam.
authors.forename: Ha
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006739:Hospital Administration / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D012727:Sex Characteristics; D012737:Sex Factors; D016896:Treatment Outcome; D014744:Vietnam / Q000453:epidemiology
references.citation: Heart. 2009 Jan;95(1):20-6
references.pmid: 18463200
references.citation: N Engl J Med. 1999 Jul 22;341(4):217-25
references.pmid: 10413733
references.citation: Eur Heart J. 2001 Feb;22(4):314-22
references.pmid: 11161950
references.citation: JAMA. 1998 Oct 28;280(16):1405-9
references.pmid: 9800999
references.citation: Circ Cardiovasc Qual Outcomes. 2010 Jan;3(1):82-92
references.pmid: 20123674
references.citation: Am J Cardiol. 1995 Jun 1;75(16):1096-101
references.pmid: 7762492
references.citation: J Int Med Res. 2013 Feb;41(1):231-8
references.pmid: 23569150
references.citation: Am J Cardiol. 2009 Mar 1;103(5):598-603
references.pmid: 19231319
references.citation: Prev Chronic Dis. 2006 Jul;3(3):A89
references.pmid: 16776890
references.citation: PLoS One. 2013 Apr 24;8(4):e62061
references.pmid: 23637963
references.citation: Am Heart J. 2008 Dec;156(6):1026-34
references.pmid: 19032996
references.citation: Am J Med. 2011 Jan;124(1):40-7
references.pmid: 21187184
references.citation: Chin Med J (Engl). 2007 Jun 20;120(12):1063-7
references.pmid: 17637223
references.citation: Clin Pharmacol Ther. 2008 Jan;83(1):37-51
references.pmid: 18043680
references.citation: Am J Cardiol. 2002 Mar 1;89(5):511-7
references.pmid: 11867033
references.citation: PLoS Med. 2013;10(1):e1001377
references.pmid: 23382655
references.citation: J Am Coll Cardiol. 2001 Sep;38(3):729-35
references.pmid: 11527625
references.citation: Am J Cardiol. 2009 Oct 15;104(8):1018-22
references.pmid: 19801017
references.citation: Heart. 2007 Nov;93(11):1369-75
references.pmid: 17933995
references.citation: Eur Heart J. 2000 Sep;21(17):1458-63
references.pmid: 10952838
references.citation: Lancet. 1999 May 8;353(9164):1547-57
references.pmid: 10334252
references.citation: J Med Assoc Thai. 2007 Oct;90 Suppl 1:65-73
references.pmid: 18431888
references.citation: PLoS One. 2011;6(10):e25904
references.pmid: 22022463
references.citation: Am J Cardiol. 2006 Oct 15;98(8):1000-3
references.pmid: 17027559