|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1997; 29:1490-1496 © 1997 by the American College of Cardiology Foundation |
Center for Cardiovascular Health Services Research, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
OBJECTIVES: This study sought to determine gender differences in hospital mortality in patients with acute cardiac ischemia. BACKGROUND: It is unclear why women experience higher mortality from acute myocardial infarction (AMI) than men and whether this applies to all patients with acute ischemia. METHODS: We analyzed data from a prospective multicenter study involving patients presenting to the emergency department (ED) with symptoms suggestive of acute ischemia. RESULTS: Of 10,783 patients, 5,221 (48.4%) were women. Mean age was 60.5 years for women and 56.9 for men (p < 0.001). Women had more hypertension (54.6% vs. 45.9%, p < 0.001) and diabetes (23.3% vs. 17.0%, p < 0.001) than men but fewer previous AMIs (21.1% vs. 28.9%, p < 0.001). Acute ischemia was confirmed in 1,090 women (20.8%) and 1,451 men (26.1%, p < 0.001), including AMI in 322 women (6.2%) and 572 men (10.3%, p < 0.001). Women with an AMI were in a higher Killip class than men: class I in 60.3% versus 72.2%, class II in 19.3% versus 16%, class III in 15.5% versus 8.7% and class IV in 5% versus 3.1%, respectively (p = 0.001). There was no significant difference in mortality from acute ischemia between genders (4.0% vs. 3.5%, p = 0.6), but there was a trend for higher AMI mortality in women (10.3% vs. 7.4%, p = 0.1). After controlling for age, diabetes, heart failure and presenting blood pressure, gender did not predict mortality from acute ischemia (odds ratio 0.9, 95% confidence interval 0.5 to 1.4, p = 0.5). CONCLUSIONS: Among patients presenting to the ED with acute cardiac ischemia, gender does not appear to be an independent predictor of hospital mortality. The trend for higher mortality in women from AMI can be explained by their older age, greater frequency of diabetes and higher Killip class on presentation.
This article has been cited by other articles:
|
|
 |
|
  C. Iribarren, I. Tolstykh, C. P. Somkin, L. M. Ackerson, T. T. Brown, R. Scheffler, L. Syme, and I. Kawachi Sex and Racial/Ethnic Disparities in Outcomes After Acute Myocardial Infarction: A Cohort Study Among Members of a Large Integrated Health Care Delivery System in Northern California Arch Intern Med, October 10, 2005; 165(18): 2105 - 2113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Wang, L. Baker, B. M. Tsai, K. K. Meldrum, and D. R. Meldrum Sex differences in the myocardial inflammatory response to ischemia-reperfusion injury Am J Physiol Endocrinol Metab, February 1, 2005; 288(2): E321 - E326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-I Cheng, K.-H. Yeh, H.-W. Chang, T.-H. Yu, Y.-H. Chen, H.-T. Chai, and H.-K. Yip Comparison of Baseline Characteristics, Clinical Features, Angiographic Results, and Early Outcomes in Men vs Women With Acute Myocardial Infarction Undergoing Primary Coronary Intervention Chest, July 1, 2004; 126(1): 47 - 53. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Rosengren, L. Wallentin, A. K. Gitt, S. Behar, A. Battler, and D. Hasdai Sex, age, and clinical presentation of acute coronary syndromes Eur. Heart J., April 2, 2004; 25(8): 663 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Bairey Merz, R. O. Bonow, G. Sopko, R. S. Balaban, R. O. Cannon III, D. Gordon, M. M. Hand, S. N. Hayes, J. F. Lewis, T. Long, et al. Women's Ischemic Syndrome Evaluation: Current Status and Future Research Directions: Report of the National Heart, Lung and Blood Institute Workshop*: October 2-4, 2002 : Executive Summary Circulation, February 17, 2004; 109(6): 805 - 807. [Full Text] [PDF]
|
|
|
|
|
|
E. G. Nabel, H. P. Selker, R. M. Califf, J. G. Canto, J. J. Cao, P. Desvigne-Nikkens, R. J. Goldberg, J. R. Finnegan Jr, V. Vaccarino, R. Virmani, et al. Women's Ischemic Syndrome Evaluation: Current Status and Future Research Directions: Report of the National Heart, Lung and Blood Institute Workshop: October 2-4, 2002: Section 3: Diagnosis and Treatment of Acute Cardiac Ischemia: Gender Issues Circulation, February 17, 2004; 109 (6): e50 - e52. [Full Text] [PDF]
|
|
|
|
 |
|
 U. N. Khot, G. Jia, D. J. Moliterno, A. M. Lincoff, M. B. Khot, R. A. Harrington, and E. J. Topol Prognostic Importance of Physical Examination for Heart Failure in Non-ST-Elevation Acute Coronary Syndromes: The Enduring Value of Killip Classification JAMA, October 22, 2003; 290(16): 2174 - 2181. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. P. Selker, J. R. Beshansky, J. L. Griffith, and for the TPI Trial Investigators* Use of the Electrocardiograph-Based Thrombolytic Predictive Instrument To Assist Thrombolytic and Reperfusion Therapy for Acute Myocardial Infarction: A Multicenter, Randomized, Controlled, Clinical Effectiveness Trial Ann Intern Med, July 16, 2002; 137(2): 87 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. A. Vakili, R. C. Kaplan, and D. L. Brown Sex-Based Differences in Early Mortality of Patients Undergoing Primary Angioplasty for First Acute Myocardial Infarction Circulation, December 18, 2001; 104(25): 3034 - 3038. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Vaccarino, H. M. Krumholz, J. Yarzebski, J. M. Gore, and R. J. Goldberg Sex Differences in 2-Year Mortality after Hospital Discharge for Myocardial Infarction Ann Intern Med, February 6, 2001; 134(3): 173 - 181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.S. Alpert Concerning gender and therapy after acute myocardial infarction: are there differences between men and women? Eur. Heart J., February 2, 2000; 21(4): 261 - 262. [PDF]
|
|
|
|
|
|
S. K. Epstein and V. Vuong Lack of Influence of Gender on Outcomes of Mechanically Ventilated Medical ICU Patients Chest, September 1, 1999; 116(3): 732 - 739. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Vaccarino, L. Parsons, N. R. Every, H. V. Barron, H. M. Krumholz, and The National Registry of Myocardial Infarction 2 P Sex-Based Differences in Early Mortality after Myocardial Infarction N. Engl. J. Med., July 22, 1999; 341(4): 217 - 225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-M. Li and G. Brooks Cell cycle regulatory molecules (cyclins, cyclin-dependent kinases and cyclin-dependent kinase inhibitors) and the cardiovascular system; potential targets for therapy? Eur. Heart J., March 2, 1999; 20(6): 406 - 420. [PDF]
|
|
|
|
 |
|
 Acute Cardiac Ischemia: Just as Deadly in Women Journal Watch Women's Health, July 1, 1997; 1997(701): 4 - 4. [Full Text]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
