title: Return to Work After Acute Myocardial Infarction: Comparison Between Young Women and Men.
abstract: BACKGROUND
  Return to work after acute myocardial infarction (AMI) is an important outcome and is particularly relevant to young patients. Women may be at a greater risk for not returning to work given evidence of their worse recovery after AMI than similarly aged men. However, sex differences in return to work after AMI has not been studied extensively in a young population (≤ 55 years).
  
  
  RESULTS
  We analyzed data from 1680 patients with AMI aged 18 to 55 years (57% women) participating in the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study who were working full time (≥ 35 hours) before the event. Data were obtained by medical record abstraction and patient interviews. We conducted multivariable regression analyses to examine sex differences in return to work at 12 months after AMI, and the association of patient characteristics with return to work. When compared with young men, young women were less likely to return to work (89% versus 85%; 85% versus 89%, P=0.02); however, this sex difference was not significant after adjusting for patient sociodemographic characteristics, psychosocial factors, and health measures. Being married, engaging in a professional or clerical type of work, having more favorable physical health, and having no previous coronary disease or hypertension were significantly associated with a higher likelihood of return to work at 12 months.
  
  
  CONCLUSIONS
  Among a young population, women are less likely to return to work after AMI than men. This disadvantage is explained by differences in demographic, occupational, and health characteristics.
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Rachel P
authors.initials: RP
authors.lastname: Dreyer
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Xiao
authors.initials: X
authors.lastname: Xu
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Weiwei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Xue
authors.initials: X
authors.lastname: Du
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Kelly M
authors.initials: KM
authors.lastname: Strait
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Maggie
authors.initials: M
authors.lastname: Bierlein
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Emily M
authors.initials: EM
authors.lastname: Bucholz
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Mary
authors.initials: M
authors.lastname: Geda
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: James
authors.initials: J
authors.lastname: Fox
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Gail
authors.initials: G
authors.lastname: D'Onofrio
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Judith H
authors.initials: JH
authors.lastname: Lichtman
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Héctor
authors.initials: H
authors.lastname: Bueno
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.affiliation: From the Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D., X.X., W.Z., K.M.S., M.B., E.M.B., M.G., J.H.L., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (R.P.D., H.M.K.), Department of Obstetrics, Gynecology, and Reproductive Sciences (X.X.), Department of Emergency Medicine (G.D.), and the Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine (H.M.K.), Yale School of Medicine, New Haven, CT; National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China (X.D.); Munson Medical Center, Traverse City, MI (J.F.); Department of Chronic Disease Epidemiology (J.H.L.) and Department of Health Policy and Management (H.M.K.), Yale School of Public Health, New Haven, CT; Centro Nacional de Investigaciones Cardiovasculares (CNIC); Instituto de Investigación i+12 and Cardiology Department, Hospital Universitario 12 de Octubre; Universidad Complutense de Madrid, Madrid, Spain (H.B.); 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.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology*; D062707:Return to Work; D012727:Sex Characteristics; D055815:Young Adult
keywords: coronary artery disease; myocardial infarction; regression analysis; sex characteristics; women