Women with complicated myocardial infarction had a higher adjusted risk of in-hospital mortality than men (4.89% vs. 2.54%; adjusted risk 1.57, P=0.006), despite similar long-term survival.
Cohort (n=5,477)
Yes
Does female sex affect short- and long-term survival in high-risk patients following complicated myocardial infarction compared to male sex?
Women with complicated AMI have a significantly higher risk of in-hospital mortality even after adjusting for age and comorbidities, highlighting the need for rapid and appropriate acute management.
Effect estimate: Adjusted risk 1.57
Absolute Event Rate: 4.89% vs 2.54%
p-value: p=0.006
AIMS: Mortality in women following an acute myocardial infarction (AMI) is higher than in men, in that women are older and have more co-morbidity at the time of AMI. We evaluated short- and long-term sex-related differences in management and prognosis among high-risk patients following AMI. METHODS AND RESULTS: A total of 1575 women and 3902 men with AMI and heart failure, left ventricular dysfunction, or anterior Q waves, were recruited for participation in the OPTIMAAL trial and followed for 2.7+/-0.9 years in seven European countries. Symptomatic heart failure was more common in women when compared with men. Women were older, with more hypertension and diabetes mellitus. Fewer women were treated with thrombolytics (P<0.001 in all cases). Women had a 1.37-fold higher risks of death (P<0.001) during follow-up, but no differences were observed after adjusting for age. However, in-hospital mortality was significantly higher in women (4.89 vs. 2.54%; P<0.001) and a 1.57-fold higher risk of in-hospital death (P=0.006) persisted after adjusting for age and co-morbidities. CONCLUSION: Among high-risk patients with AMI, age-adjusted long-term survival was similar between sexes. However, adjusted in-hospital mortality was significantly higher in women. Higher short-term risk may warrant more rapid and appropriate management of women with AMI.
Vernon Bonarjee (2006) conducted a cohort in Acute myocardial infarction with heart failure, left ventricular dysfunction, or anterior Q waves (n=5,477). Female sex vs. Male sex was evaluated on In-hospital mortality (Adjusted risk 1.57, p=0.006). Women with complicated myocardial infarction had a higher adjusted risk of in-hospital mortality than men (4.89% vs. 2.54%; adjusted risk 1.57, P=0.006), despite similar long-term survival.