title: Gender differences in the trajectory of recovery in health status among young patients with acute myocardial infarction: results from the variation in recovery: role of gender on outcomes of young AMI patients (VIRGO) study.
abstract: BACKGROUND
  Despite the excess risk of mortality in young women (≤55 years of age) after acute myocardial infarction (AMI), little is known about young women's health status (symptoms, functioning, quality of life) during the first year of recovery after an AMI. We examined gender differences in health status over time from baseline to 12 months after AMI.
  
  
  RESULTS
  A total of 3501 AMI patients (67% women) 18 to 55 years of age were enrolled from 103 US and 24 Spanish hospitals. Data were obtained by medical record abstraction and patient interviews at baseline hospitalization and 1 and 12 months after AMI. Health status was measured by generic (Short Form-12) and disease-specific (Seattle Angina Questionnaire) measures. We compared health status scores at all 3 time points and used longitudinal linear mixed-effects analyses to examine the independent effect of gender, adjusting for time and selected covariates. Women had significantly lower health status scores than men at each assessment (all P values <0.0001). After adjustment for time and all covariates, women had Short Form-12 physical/mental summary scores that were -0.96 (95% confidence interval [CI], -1.59 to -0.32) and -2.36 points (95% CI, -2.99 to -1.73) lower than those of men, as well as worse Seattle Angina Questionnaire physical limitations (-2.44 points lower; 95% CI, -3.53 to -1.34), more angina (-1.03 points lower; 95% CI, -1.98 to -0.07), and poorer quality of life (-3.51 points lower; 95% CI, -4.80 to -2.22).
  
  
  CONCLUSIONS
  Although both genders recover similarly after AMI, women have poorer scores than men on all health status measures, a difference that persisted throughout the entire year after discharge.
authors: From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.). rachel.dreyer@yale.edu.
authors: Rachel P
authors: RP
authors: Dreyer
authors: From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).
authors: Yongfei
authors: Y
authors: Wang
authors: From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).
authors: Kelly M
authors: KM
authors: Strait
authors: From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).
authors: Nancy P
authors: NP
authors: Lorenze
authors: From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).
authors: Gail
authors: G
authors: D'Onofrio
authors: From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).
authors: Héctor
authors: H
authors: Bueno
authors: From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).
authors: Judith H
authors: JH
authors: Lichtman
authors: From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).
authors: John A
authors: JA
authors: Spertus
authors: From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (R.P.D., Y.W., K.M.S., N.P.L., J.H.L., H.M.K.); Section of Cardiovascular Medicine (R.P.D., Y.W., H.M.K.) and the Robert Wood Johnson Foundation Clinical Scholars Program (H.M.K.), and Department of Emergency Medicine (G.D.), Yale School of Medicine, New Haven, CT; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Gregorio Marañón, and Universidad Complutense de Madrid, Spain (H.B.); Departments of Chronic Disease Epidemiology (J.H.L.) and Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; University of Missouri, Kansas City, School of Medicine, Biomedical & Health Informatics (J.A.S.); and Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.).
authors: Harlan M
authors: HM
authors: Krumholz
mesh_terms: D000328:Adult; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D012307:Risk Factors; D012727:Sex Characteristics; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: gender characteristics; health status; myocardial infarction; prognosis; women