Association of Age and Sex With Myocardial Infarction Symptom Presentation and In-Hospital Mortality

ContextWomen are generally older than men at hospitalization for myocardial infarction (MI) and also present less frequently with chest pain/discomfort. However, few studies have taken age into account when examining sex differences in clinical presentation and mortality.ObjectiveTo examine the relationship between sex and symptom presentation and between sex, symptom presentation, and hospital mortality, before and after accounting for age in patients hospitalized with MI.Design, Setting, and PatientsObservational study from the National Registry of Myocardial Infarction, 1994-2006, of 1 143 513 registry patients (481 581 women and 661 932 men).Main Outcome MeasuresWe examined predictors of MI presentation without chest pain and the relationship between age, sex, and hospital mortality.ResultsThe proportion of MI patients who presented without chest pain was significantly higher for women than men (42.0% 95% CI, 41.8%-42.1% vs 30.7% 95% CI, 30.6%-30.8%; P ConclusionIn this registry of patients hospitalized with MI, women were more likely than men to present without chest pain and had higher mortality than men within the same age group, but sex differences in clinical presentation without chest pain and in mortality were attenuated with increasing age.