title: Sex-specific trends in 4-year survival in 37 276 men and women with acute myocardial infarction before the age of 55 years in Sweden, 1987-2006: a register-based cohort study.
abstract: OBJECTIVE
  To examine sex-specific trends in 4-year mortality among young patients with first acute myocardial infarction (AMI), 1987-2006.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Sweden.
  
  
  METHODS
  We identified 37 276 cases (19.4% women; age, 25-54 years) from the Swedish Inpatient Register, 1987-2006, who had survived 28 days after an AMI.
  
  
  METHODS
  4-year mortality from all causes and standard mortality ratio (SMR).
  
  
  RESULTS
  From the first to last 5-year period, the absolute excess risk decreased from 1.38 to 0.50 and 1.53 to 0.59 per 100 person-years among men aged 25-44 and 45-54 years, respectively. Corresponding figures for women were a decrease from 2.26 to 1.17 and from 1.93 to 1.45 per 100 person-years, respectively. Trends for women were non-linear, decreasing to the same extent as those for men until the third period, then increasing. For the last 5-year period, the standardised mortality ratio for young survivors of AMI compared with the general population was 4.34 (95% CI 3.04 to 5.87) and 2.43 (95% CI 2.12 to 2.76) for men aged 25-44 and 45-54 years, respectively, and 13.53 (95% CI 8.36 to 19.93) and 6.42 (95% CI 5.24 to 7.73) for women, respectively. Deaths not associated with cardiovascular causes increased from 21.5% to 44.6% in men and 41.5% to 65.9% in women.
  
  
  CONCLUSIONS
  Young male survivors of AMI have low absolute long-term mortality rates, but these rates remain twofold to fourfold that of the general population. After favourable development until 2001, women now have higher absolute mortality than men and a 6-fold to 14-fold risk of death compared with women in the general population.
authors.affiliation: Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Nielsen
authors.forename: L
authors.initials: L
authors.lastname: Björck
authors.forename: J
authors.initials: J
authors.lastname: Berg
authors.forename: K W
authors.initials: KW
authors.lastname: Giang
authors.forename: T
authors.initials: T
authors.lastname: Zverkova Sandström
authors.forename: K
authors.initials: K
authors.lastname: Falk
authors.forename: S
authors.initials: S
authors.lastname: Määttä
authors.forename: A
authors.initials: A
authors.lastname: Rosengren
mesh_terms: D000208:Acute Disease; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D012042:Registries; D017678:Sex Distribution; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors