title: Sex differences in the non-invasive risk stratification and prognosis after myocardial infarction.
abstract: BACKGROUND
  Women have unfavorable prognosis after myocardial infarction (MI). This text describes sex differences in mortality and in the power of risk predictors in contemporarily-treated MI patients.
  
  
  METHODS
  A population of 4141 MI patients (26.5% females) was followed up for 5years. Effects of sex and age on total mortality were investigated by multivariable Cox analysis. Mortality predictors were investigated by receiver-operator characteristics analysis. Stepwise multivariable Cox regression was used to create sex-specific predictive models.
  
  
  RESULTS
  Thirty-day mortality was 1.5-fold higher in women. However, sex was not a significant mortality predictor in a model adjusted for age. Predictors for 5-year mortality performed differently in male and female patients. In women, a sex-specific model provided better risk stratification than a sex-neutral model.
  
  
  CONCLUSIONS
  The unfavorable prognosis of female MI patients can be explained by advanced age. Sex-specific predictive models might improve risk stratification in female survivors of acute MI.
authors.affiliation: Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sinnecker
authors.affiliation: Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Katharina M
authors.initials: KM
authors.lastname: Huster
authors.affiliation: Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Müller
authors.affiliation: Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Dommasch
authors.affiliation: Institut für Medizinische Statistik und Epidemiologie, Technische Universität München, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hapfelmeier
authors.affiliation: Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Josef
authors.initials: J
authors.lastname: Gebhardt
authors.affiliation: Saint Paul's Cardiac Electrophysiology, London, UK; Saint George's, University of London, London, UK.
authors.forename: Katerina
authors.initials: K
authors.lastname: Hnatkova
authors.affiliation: Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.affiliation: Saint Paul's Cardiac Electrophysiology, London, UK; Imperial College, London, UK.
authors.forename: Marek
authors.initials: M
authors.lastname: Malik
authors.affiliation: Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Barthel
authors.affiliation: Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research, partner site Munich Heart Aliance), Berlin, Germany. Electronic address: gschmidt@tum.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Schmidt
mesh_terms: D017677:Age Distribution; D000368:Aged; D015716:Electrocardiography, Ambulatory / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012727:Sex Characteristics; D017678:Sex Distribution; D015996:Survival Rate
keywords: ECG; Gender; Myocardial infarction; Risk stratification